Electrical Cardioversion Can Be Performed by Advanced Practice Provider

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After initiation of APP-driven cardioversions, patient satisfaction scores were stable.
After initiation of APP-driven cardioversions, patient satisfaction scores were stable.

HealthDay News — An advanced practice provider (APP) can safely perform electrical cardioversion (CV) for atrial fibrillation, according to a study published in JACC: Clinical Electrophysiology.

Theresa A. Strzelczyk, APN, from Northwestern Memorial Hospital in Chicago, and colleagues compared outcomes for CVs performed by a licensed advanced practice nurse-clinical nurse specialist who was trained and credentialed to perform CVs (APP group; 415 procedures) with 387 CVs performed by a physician when the APP was not available (MD group).

The researchers observed no significant difference in the proportion of patients discharged in sinus rhythm in the APP and MD groups (95% and 96%, respectively; P = .49). 

Four adverse events were reported in the APP group: 1 transient ischemic attack and 3 occurrences of bradycardia requiring atropine or other medication. One adverse event (hypotension requiring vasopressor initiation) was reported in the MD group. After initiation of APP-driven cardioversions, patient satisfaction scores were stable.

"With appropriate clinical training, a protocol that includes a guideline-directed procedural checklist, and physician supervision, an APP can safely perform CVs autonomously with excellent patient satisfaction and outcomes," the researchers write.

Reference

Strezelczyk TA, Kaplan RM, Medler M, Knight BP. Outcomes associated with electrical cardioversion for atrial fibrillation when performed autonomously by an advanced practice provider [published online June 2017]. JACC: Clinical Electrophysiology. DOI: 10.1016/j.jacep.2017.04.004

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