A South Australian Registry of Biphasic Cardioversions of XXXX : Efficacy and Predictors of Success.

@entity1 @entity943
BACKGROUND: Restoration of sinus rhythm by biphasic cardioversion is an established strategy for @entity1 in @entity943 . This study aimed to investigate the real-life practice of cardioversions throughout a local hospital to determine frequency and predictors of success and use of high energy (> 200 joules). METHODS: Prospective analysis of consecutive biphasic cardioversions from 2009-2013. @entity1 demographics, medical history and cardioversion data were collected. RESULTS: 484 cardioversions from 379 @entity1 were included in the final analysis. The majority (73%) of cardioversions were immediately successful after a single shock; overall success was 88% (1-5 shocks). Exploratory analyses revealed that single-shock success was significantly associated with lighter weight (OR 1.19, 95% CI 1.0-1.4, p<0.05). If a second shock was required, energy escalation was significantly associated with success (OR 3.11, 95% CI 1.43-6.77, p<0.05). Increasing weight was the strongest predictor of receiving high energy (10kg increase OR 1.43, 95% CI 1.13-1.81, p<0.05). CONCLUSIONS: This prospective analysis reflects the real-life heterogeneous practice of biphasic cardioversions of @entity943 throughout a local hospital. These findings highlight the importance of first shock energy selection with careful consideration of @entity1 weight. We emphasise the recommendation to escalate energy, highlighting the need for high-energy defibrillators in 'hard-to-cardiovert' @entity1 .
