Arrhythmias & electrophysiologyResearch article
Cardioversion of atrial fibrillation and flutter: Trends, outcomes, and rhythm management strategies over 2 decades
- multi-institutional experience of direct current cardioversion (DCCV) over 2 decades
- case-level analyses
- patient-level analyses
Authors' conclusion
DCCV case volume has increased markedly, and subsequent catheter ablation is increasingly common. Findings highlight a growing preference for rhythm control and emphasize the importance of scaling access to DCCV.
Study context
- Population
- Patients undergoing direct current cardioversion (DCCV) for atrial fibrillation and flutter (AF/AFL), 2000–2024DCCVs (case-level), 19,848 patients with index DCCV between 2000 and 2022 · DCCVs 44,043 · patients with index DCCV 19,848
- Participants
- 44,043 patients
Main finding
As reported in the abstract
Annual DCCV cases · 2000 to 2024
2000
857
2024
3999
Further findings
Patient status at DCCV
- outpatient
- n = 21,966; 49.9%
- inpatient
- n = 17,833; 40.5%
Cumulative risk of AF/AFL recurrence after index DCCV · 1 year and 5 years
- 1 year
- 50.5% (95% CI 49.8-51.2)
- 5 years
- 75.4% (95% CI 74.7-76.2)
5-year cumulative risk of incident stroke, incident heart failure (HF), HF hospitalization
- incident stroke
- 15.8% (95% CI 15.2-16.4)
- incident HF
- 28.1% (95% CI 27.2-29.1)
- HF hospitalization
- 24.9% (95% CI 24.2-25.6)
Catheter ablation within 2 years after index DCCV
- increased substantially over time
Baseline characteristics of patients with index DCCV
- age
- 66.9 ± 12.9 years
- female
- 31.5%
Original publication
Cardioversion of atrial fibrillation and flutter: Trends, outcomes, and rhythm management strategies over 2 decades. Heart Rhythm. Published 22 October 2025. doi:10.1016/j.hrthm.2025.10.037
Summarised from the published abstract; every number is checked against it