Seven Years Experience of a Nurse-Led Elective Cardioversion Service in a Tertiary Referral Centre: An Observational Study

BackgroundTraditionally the provision of elective external direct current cardioversion (EDCCV) for patients with atrial arrhythmias has been doctor-led. Increasing demands on hospital beds and time pressures for doctors has driven the desire for an alternative approach. We established a nurse-led cardioversion service in 2006 and present our experience.MethodsA prospective database of patients undergoing elective EDCCV between July 2006 and July 2013 was collected. Demographic data, arrhythmia, success and immediate complications of cardioversion were recorded.ResultsA total of 974 EDCCV were performed on 772 patients. The mean patient age was 62.7 years, 564 (73.1%) were male. In 530 patients (69.0%) AF was the primary arrhythmia, in 242 (31.0%) atrial flutter. All EDCCVs were performed in a high dependency unit. Sinus rhythm was obtained in 692 patients (89.6%). Of 640 outpatients, 629 (98.3%) were discharged on the same day of their procedure. Eleven patients (1.7%) required admission to hospital. No patients required urgent temporary transvenous or permanent pacing, and there were no deaths in association with this procedure.ConclusionsNurse-led elective EDCCV is a safe and effective way of restoring sinus rhythm in patients with AF or atrial flutter, with additional benefits to resource provision.