AF: cardiovesrion in the community hospital

AF

Most prevalent heart arrhythmia

Prevalence increases with age

Causes strokes, heart failure, burdersome symptoms

Typical trajectory from short burst of arrhythmia to permanent form

Treatment

Anticoagulation to prevent strokes

No one knows what to do to prevent heart failure

Rhythm restoration reduces symptoms

Sinus restoration does not prevent heart failure?

DC cardioversion

Syncronized electric shock under sedation

Effective and fast way to restore symptoms

Can be done on outpatient basis (rarely done in Russia)

Procedures (trajectories)

Community hospital practice

2,500 procedures in ~800 patients during 15 years

More than half done in outpatients

Data available

Safety and immediate efficacy data available

Demographic data

Connection with echocardiography database (weight, height, cardiac function)

Data on repeated procedures

Goal

Describe feasibility of the procedure in settings of community hospital

Population demand in procedures

Barriers to its implemenations

Ways to implement the AF treament service in the community