Outcomes Associated With Electrical Cardioversion for Atrial Fibrillation When Performed Autonomously by an Advanced Practice Provider

Abstract

With appropriate clinical training, an APP can safely perform CVs autonomously, using a protocol that includes a guideline-directed procedural checklist and physician supervision, with excellent patient satisfaction and outcomes.

The impact of a nurse‐led elective direct current cardioversion in atrial fibrillation on patient outcomes: A systematic review

“…The highest score achieved was 68% in the study by Norton et al (), and the lowest score was 38% by Quinn (). Boodhoo et al () study scored 51.72%, House et al () study scored 57%, Strezelczyk et al () study scored 50%, Moore et al () study scored 60%, and Shelton et al () study scored 40%.…”

“…The interventions of the individual studies varied with different educational qualifications such as RGN, ANP/APP/NP). Boodhoo et al (), House et al (), Norton et al () and Strezelczyk et al () compared the intervention group with medical‐led procedures. All articles highlighted that prior to performing elective DCCVs, all interventions have performed minimum of twenty DCCVs under direct supervision of physicians.…”

“…All seven included studies reported on nurse‐led elective DCCV success rates; four of these were comparative studies (Boodhoo et al, ; House et al, ; Norton et al, ; Strezelczyk et al, ). Figure displays the percentage of success rate in restoration to sinus rhythm in all studies.…”

“…Four studies (Boodhoo et al, ; House et al, ; Norton et al, ; Strzelczyk et al, ) compared the outcome of nurse‐led DCCVs with medical‐led procedures (Figure ). A prospective longitudinal study by Boodhoo et al () aimed to determine the safety and effectiveness of nurse‐led DCCV.…”

“…Additionally, Strzelczyk et al () carried out a study on the outcomes of DCCV performed autonomously by APP including APNs. APP/APNs performed 415 DCCVs, and during the same period, a cardiology fellow performed 387 under supervision.…”