Naomi Lollback, Leanne Slater, Peter Moore, John Hill, Gould P and Kaye G
Princess Alexandra Hospital, Australia
Scientific Tracks Abstracts: J Nurs Care
Introduction: External DC cardio version (EDCCV) is a standard procedure for treatment of tachyarrhythmias. Objective: A review of an outpatient-based cardioversion service led by a cardiac trained electrophysiology and pacing nurse consultant (CNC). Methods: A review of patients (pts), referred from the general hospital population was undertaken from 2006-2015. Patients were included only if they had adequate, continuous anticoagulation monitored by the CNC in the 3 weeks prior to EDCCV and reviewed in a preadmission clinic where informed consent was obtained by a junior cardiology registrar. The CNC directed all procedures as day cases, in a high dependency cardiac monitoring unit in the presence of an anesthetist and a trainee cardiology registrar. A consultant cardiologist attended patients with a pacemaker or defibrillator. Results: EDCCV was performed in 729 patients, 74% males, median age 65 yrs (range 23-95) in whom 73% had atrial fibrillation and 27% atrial flutter. Biphasic external shock, range 50-200 J, was applied with an anterior posterior vector. The mean shock energy was 155 J with a mean number 1.35+0.16 (range 1-4) per patient. The success rate was 89%. Patients were usually discharged within 4 hours but 13 required admission; 1 asystole requiring external pacing, 5 admitted for sinus bradycardia, 1 for bronchospasm and hypotension, and 5 for temporary heart block needing monitoring. One patient suffered a CVA 12 hour├ó┬?┬?s post procedure. There were no deaths or other serious morbidity. Conclusion: An EDCCV service run by a trained and experienced electrophysiology nurse in a monitored environment is safe and effective.
Naomi Lollback has completed her Bachelor of Nursing from Griffith University, Australia and has completed a Post-graduate Certificate in Advanced Practice Nursing from the University of Queensland. She is a Clinical Nurse in the Coronary Care Unit at the Princess Alexandra Hospital, Brisbane, Australia, and has worked in the acting role of Electrophysiology and Pacing Clinical Nurse Consultant for the last two years. She has published 2 papers in reputed journals.
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