Safety of Elective Electrical Cardioversion for Atrial Fibrillation or Flutter

Because of concerns about complications such as stroke or other thromboembolic events, physicians might hesitate to use cardioversion in patients who present with atrial fibrillation or flutter. Researchers retrospectively evaluated 30-day outcomes in 400 patients who underwent elective electrical cardioversion for atrial fibrillation or flutter at two emergency departments (EDs) in British Columbia during an 8-year period.

Cardioversion was successful within three attempts in 97% of patients. All but three patients had CHADS₂ scores ≤1 (corresponding to an estimated annual stroke risk <3%); see the table. Patients were generally healthy, and 94% had self-reported symptom duration of <24 hours. Patients with symptom duration >48 hours were c…