Electrical cardioversion of atrial fibrillation or flutter with conscious sedation in the age of cost containment
Autor: | Bruce G. Goldner, Vincent Zambrotta, Anthony Accordino, Ram Jadonath, Jaime Stechel, David Lin, Michael DiGiulio, Jennifer Baker, Donna Kalenderian, Paul Maccaro, Lou Sabatino |
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Rok vydání: | 1998 |
Předmět: |
Male
medicine.medical_specialty Cost Control medicine.drug_class Defibrillation Midazolam Sedation medicine.medical_treatment Conscious Sedation Electric Countershock New York Cardioversion Anesthesiology Atrial Fibrillation medicine Humans Propofol Aged Aged 80 and over business.industry Atrial fibrillation Middle Aged medicine.disease Hospital Charges Surgery Analgesics Opioid Electrophysiology Atrial Flutter Sedative Anesthesia Female medicine.symptom Anesthesia Department Hospital Cardiology and Cardiovascular Medicine business Anesthetics Intravenous Atrial flutter medicine.drug |
Zdroj: | American Heart Journal. 136:961-964 |
ISSN: | 0002-8703 |
Popis: | Background The purpose of this study was to compare the safety, efficacy, and cost of conscious sedation administered by electrophysiologists certified in the use of conscious sedation with sedation administered by anesthesiologists during cardioversion of atrial fibrillation or atrial flutter to sinus rhythm. Methods and Results Patients with hemodynamically stable persistent atrial fibrillation and flutter were included in this study. Group 1 patients ( n = 33) were sedated by an anesthesiologist and group 2 patients ( n = 26) were sedated by an electrophysiologist. Anesthesiologists used propofol and electrophysiologists used midazolam and morphine for sedation. A cost analysis based on professional charges and cost of medications was performed for both groups and compared. Hospital charges were similar for both groups and were excluded from the cost analysis. Although time to sedation in group 1 was shorter than that in group 2, sedation was adequate in both groups such that no patient in group 1 and only 1 patient in group 2 recalled being shocked. There were no complications in either group. The cost incurred in group 2 was less than that in group 1. Conclusions Sedation administered by electrophysiologists for cardioversion of atrial arrhythmias is safe and cost effective. Midazolam and morphine, the sedative agents administered by electrophysiologists, were effective and well tolerated by patients. (Am Heart J 1998;136:961-4.) |
Databáze: | OpenAIRE |
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