[Optimal observation period after an electrical cardioversion under sedation]
Bussières S, Lacasse Y
Record ID 32018013271
French
Original Title:
Durée optimale du temps d'observation à la suite d'une cardioversion électrique : revue de la littérature et évaluation en contexte réel de soins
Authors' objectives:
Atrial fibrillation is the most common arrhythmia encountered in emergency departments. When electrical cardioversion (ECV) is deemed necessary, a procedural sedation is required to decrease the level of consciousness during the procedure and that it takes place in the absence of pain. The observation period following an ECV involving procedural sedation is currently two hours at the Institute. In order to improve fluidity in the emergency department and in the outpatient electrophysiology unit, the Professional Services Directorate requested that the Institute's Health Technology Assessment Unit evaluate whether reducing the observation period from two hours to one hour following an ECV is safe and effective
Authors' results and conclusions:
Among the recommendations from professional societies regarding the monitoring and surveillance of patients following a sedation and analgesia procedure, no recommendation was specifically related to follow up and the observation period following an ECV. In the studies of patients undergoing ECV, the time delay between sedation, ECV, and adverse events were not reported, which was an important limitation. In this context, an evaluation of adverse events occurring following ECV using real-world data from the Institute was carried out. The results of this retrospective study suggest that all major adverse events following an ECV in the outpatient electrophysiology unit (outpatient) and in the emergency department occur within the first 36 minutes following the procedure.
Authors' recommendations:
In this context, it is recommended that the Institute reduce the observation period from two hours to one hour following an ECV for the management of patients suffering from atrial fibrillation or flutter in the electrophysiology unit (outpatient) and at the emergency department. We also suggest several patient and monitoring criteria that must be satisfied prior to discharge to ensure a safe transition from hospital to home.
Details
Project Status:
Completed
URL for project:
https://www.iucpq.ca/a-propos-de-nous/excellence/evaluation-des-technologies-et-modes-dintervention-en-sante/
Year Published:
2024
URL for published report:
https://www.iucpq.ca/app/uploads/2024/08/rap_cardioversion_07-24.pdf
Requestor:
Professional Services Directorate
English language abstract:
An English language summary is available
Publication Type:
Full HTA
Country:
Canada
MeSH Terms
- Atrial Fibrillation
- Electric Countershock
- Arrhythmias, Cardiac
- Deep Sedation
- Conscious Sedation
- Monitoring, Physiologic
- Patient Care
- Aftercare
- Anesthesia
- Anesthesia Recovery Period
Contact
Organisation Name:
Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-ULaval)
Contact Address:
2725, chemin Sainte-Foy Québec QC G1V 4G5
Contact Name:
uetmis.iucpq@ssss.gouv.qc.ca
Contact Email:
uetmis.iucpq@ssss.gouv.qc.ca
Copyright:
Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.