Heart, Lung and Circulation
Volume 17, Issue 3 , Pages 211-214, June 2008

Transoesophageal Echocardiography And Cardioversion: Feasibility of A Combined Approach in Clinical Practice

  • Liza Thomas, FRACP

      Affiliations

    • Department of Cardiology, Westmead Hospital, Darcy Road, Sydney, NSW 2145, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 2 98456795; fax: +61 2 98458323.
  • ,
  • Michael Veltman, FRACP

      Affiliations

    • Department of Anaesthesia, Westmead Hospital, Sydney, NSW 2145, Australia
  • ,
  • Kate Levett, BEd (HME) Hons

      Affiliations

    • Department of Cardiology, Westmead Hospital, Darcy Road, Sydney, NSW 2145, Australia
  • ,
  • Michelle Hoy, BSci(Biomedical)

      Affiliations

    • Department of Cardiology, Westmead Hospital, Darcy Road, Sydney, NSW 2145, Australia
  • ,
  • David L. Ross, FRACP

      Affiliations

    • Department of Cardiology, Westmead Hospital, Darcy Road, Sydney, NSW 2145, Australia

Received 5 March 2007; received in revised form 2 August 2007; accepted 29 October 2007.

Background

Atrial fibrillation, the most common clinically important arrhythmia, is often treated by external cardioversion preceeded by transoesophageal echo (TOE) which are usually performed as separate procedures. We performed TOE and cardioversion as a combined procedure to evaluate its safety and feasibility.

Method

173 patients were referred for a combined procedure; 154 underwent a combined TOE and cardioversion. We evaluated the safety and the duration of hospital stay in this group of patients. A cost analysis was performed comparing 32 patients (Group 1) who had a combined procedure in the first 6 months, with 18 patients who had two separate procedures (Group 2) in the 6 months preceeding this.

Results

Analysis of 154 patients who underwent the combined procedure demonstrated a median time from admission to discharge of 9h with a mean procedure time of 36min. No significant technical problems were identified with the combined procedure as a single sedation. Total admission time, TOE to discharge time (p<0.0001) and procedural costs were lower in Group 1.

Conclusion

Combined TOE and cardioversion is an effective and safe procedure that permits a patient to have a single sedation with a short hospital stay with decreased health costs.

Keywords: Tranoesophageal echocardiography, Cardioversion, Atrial fibrillation, Cost benefit

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PII: S1443-9506(07)01075-X

doi:10.1016/j.hlc.2007.10.010

Heart, Lung and Circulation
Volume 17, Issue 3 , Pages 211-214, June 2008