EVALUATION OF A PROTOCOL TO SELECT PATIENTS OF ALL AGES FOR CARDIOVERSION FROM ATRIAL-FIBRILLATION

Objective: to audit the success of a decision protocol to select patie nts for cardioversion from atrial fibrillation or flutter by recording the success of cardioversion and the maintenance of sinus rhythm over a 2-year period. Design: retrospective case notes review. Setting: a teaching hospital coronary care unit and cardiology department. Patien ts: 227 consecutive patients were considered for cardioversion from at rial fibrillation or flutter from 1989 to 1992; 128 fulfilled the sele ction criteria. Main outcome measures: successful cardioversion and ma intenance of sinus rhythm after cardioversion. Results: 116 (91%) pati ents selected by application of the guidelines were successfully cardi overted. The probabilities of maintaining sinus rhythm at 6, 12 and 24 months were 0.92, 0.88 and 0.73 respectively. Conclusion: careful sel ection of patients in atrial fibrillation identities a group in whom c ardioversion is likely to be safe and successful regardless of age.