SAFETY AND EFFICACY OF IN-OFFICE CARDIOVERSION FOR TREATMENT OF SUPRAVENTRICULAR ARRHYTHMIAS

Direct-current cardioversion has been an accepted technique for the correction of supraventricular arrhythmias nearly since its introduction by Lown et al in 1962.1 Although multiple reports documenting complications, and describing potential complications of this procedure have been reported,2-4 its overall safety has been well demonstrated both for emergent as well as elective intervention over the past 25 years.5 In fact, we now routinely treat patients for life-threatening arrhythmias as "outpatients" with the automatic implantable cardioverter-defibrillator.6,7 Despite this, few, if any, published reports are available on the routine use of this in-office technique to correct common supraventricular arrhythmias such as atrial fibrillation and atrial flutter. Use of this technique has been reported in an outpatient setting in a hospital emergency room8 not only with excellent efficacy and safety, but also with rapid (2 hours) discharge and ambulation. This report describes our results of a routine procedure for countershock therapy applied to outpatients in a routine, in-office setting. © 1990.