Abstract

Aim: To investigate the determinants of successful cardioversion in selective group of patients admitted electively for electrical cardioversion (DCCV) in our center. Method: Charts of patients admitted for DCCV in CCU at our center were audited. Total of 58 patients underwent DCCV during our study period. Variable used were age, gender, comorbidities such as HTN, DM, COPD, CKD, anemia, IHD, CVA or TIA. We calculated CHA2DS VASC and HAS Bled Score. We looked through their echo study including their EF, L a size, RVD, any valvular disease. Results: A total of 58 patient charts were studied, age group and their comorbidities were recorded. The common comorbidity was HTN 68.9%, followed by obesity 39.6%, IHD 22.41%. COPD in 12.06%. DM and CKD were of equal prevalence - 6.89%. Anemia, CVA or TIA were noted in 3.44% and 1.7% patients respectively. CHA2DS VASC and HASBLED score was also recorded. Echocardiogram findings are as below. EF of 20-30% was noted in 6 patients, 35-45% in 5 patients, 45-55% in 15 patients and >55% in 27 patient. Echo was not done in 5 patients. Poor images noted in 2 patients. LA size was reported as normal in 21 patients, 12 patients had mild enlargement of LA while others had moderate to severely enlarged (>5.0cm) LA. The LA size in 9 patients could not be assessed accurately. Conclusion: There is no historical data available to report on individual determinants of success of DCCV. We observed that normal LA size is an independent decisive factor in successful restoration of SR from AF followed by optimal blood pressure control and obesity. In another subset of this, we also noted that two or more medical comorbidities with moderately enlarged LA had difficulty in restoration of SR with DCCV.