Delayed vs early cardioversion in patients with paroxysmal atrial fibrillation: a population-based study (2015-2020).
Mohamed Salah MohamedAnas HashemAmani KhaloufMuhammad OsamaVenkata Satish PendelaDevesh RaiWilbert S AronowMallory Balmer-SwainPublished in: Future cardiology (2023)
Aim: There is limited data on clinical outcomes of delayed cardioversion (DCV) compared with early cardioversion (ECV) in paroxysmal atrial fibrillation (AF) patients. Methods: We utilized data from National Inpatient Sample (2015-2020) and propensity-score matched analysis to determine adjusted odds ratio (aOR) of major clinical outcomes, including 17,879 AF cases: 9725 and 8154 underwent ECV and DCV, respectively. Results: Compared with ECV, DCV was associated with higher odds of acute heart failure (AHF) (aOR 1.79 [1.67-1.92]; p < 0.01), median length of stay (4 vs 2 days; p < 0.01), and cost of hospitalization ($33,410 vs $21,738; p < 0.01) with no significant difference in inpatient mortality and other cardiovascular and neurological outcomes. Conclusion: Compared with ECV, DCV was associated with more AHF and resource utilization.
Keyphrases
- atrial fibrillation
- catheter ablation
- oral anticoagulants
- left atrial
- acute heart failure
- heart failure
- left atrial appendage
- direct oral anticoagulants
- end stage renal disease
- electronic health record
- ejection fraction
- palliative care
- mental health
- chronic kidney disease
- newly diagnosed
- big data
- cardiovascular events
- type diabetes
- patient reported outcomes
- quality improvement
- skeletal muscle
- metabolic syndrome
- blood brain barrier
- artificial intelligence
- data analysis
- deep learning
- brain injury