Takeaway
- For noncardiac postsurgical patients with Afib, electrical cardioversion (ECV) to sinus rhythm (SR) is more successful among those whose serum potassium was ≥3.8 mol/L.
- Results underscore those of previous studies.
Why this matters
- Few data address Afib incidence or ECV success rates in noncardiac surgical ICU patients.
Key results
- ECV succeeded in 48% of patients (41).
- Of those, 73% (30) experienced recurrent Afib.
- Among the 44 patients whose ECV was unsuccessful, 37 returned to SR during ICU stay.
- ECV success was predicted by serum K≥3.8 mol/L on multivariate analysis adjusted for arterial pH: OR, 3.13 (95% CI, 1.07-9.11; P=.04).
- ICU success was predicted by 2 factors on multivariate analysis adjusted for APACHE score:
- Higher arterial pH (per 0.1 increase): OR, 3.02 (95% CI, 1.61-5.67; P=.0006); and
- SR maintained until ICU discharge: OR, 9.35 (95% CI, 1.02-85.78; P=.048).
Study design
- Retrospective single-center observational study of ICU patients with new-onset Afib undergoing ECV (n=85).
- Authors assessed predictors of cardioversion success, mortality.
- Funding: None.
Limitations
- Small single-center study, limited to patients with new-onset Afib.
- Serum magnesium data were mostly missing.
- ECV energies varied.
References
References