Evidence map›Paper›PMID 34238390›Full record

ArticleJournal of intensive care2021

Primary success of electrical cardioversion for new-onset atrial fibrillation and its association with clinical course in non-cardiac critically ill patients: sub-analysis of a multicenter observational study.

Nozomu Shima, Kyohei Miyamoto, Seiya Kato, Takuo Yoshida, Shigehiko Uchino, AFTER-ICU study group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Thromboembolic risk of electrical cardioversion in patients with cardiogenic shock.International journal of cardiology. Heart & vasculature · 2025
    Article
  3. Review
  4. Review
  5. Acute rate control in atrial fibrillation: an urgent need for the clinician.European heart journal supplements : journal of the European Society of Cardiology · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Nozomu ShimaDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan. nozowmu@wakayama-med.ac.jp.ORCID http://orcid.org/0000-0002-9670-754X
Kyohei MiyamotoDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan.
Seiya KatoDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan.
Takuo YoshidaIntensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan.
Shigehiko UchinoIntensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan.
AFTER-ICU study group
Wakayama Medical University · JPJikei University School of Medicine · JPTokyo Women's Medical University · JP

Funding

the Jikei University Research Fund none
6 · The paper itself

Abstract

backgroundElectrical cardioversion (ECV) is widely used to restore sinus rhythm in critically ill adult patients with atrial fibrillation, although its prognostic value is uncertain. This study aims to elucidate the clinical meaning of successful ECV.

methodsThis is a sub-analysis of the AFTER-ICU study, a multicenter prospective study with a cohort of 423 adult non-cardiac patients with new-onset atrial fibrillation (AF). Patients that underwent ECV within 7 days after initial onset of AF were included in the sub-analysis. We compared intensive care unit (ICU) and overall hospital mortality, survival time within 30 days, cardiac rhythm at ICU discharge, and the length of ICU and overall hospital stay between patients whose sinus rhythm was restored immediately after the first ECV session (primary success group) and those in whom it was not restored (unsuccessful group). To find the factors related to the primary success of ECV, we also compared patient characteristics, the delivered energy, and pretreatment.

resultsSixty-five patients received ECV and were included in this study. Although 35 patients (54%) had primary success, recurrence of AF occurred in 24 of these patients (69%). At ICU discharge, three patients still had AF in the unsuccessful group, but no patients in the primary success group still had AF. ICU mortality was 34% in the primary success group and 17% in the unsuccessful group (P = 0.10). Survival time within 30 days did not differ between the groups. Delivered energy and pretreatment were not associated with primary success of ECV.

conclusionsThe primary success rate of ECV for new-onset AF in adult non-cardiac ICU population was low, and even if it succeeded, the subsequent recurrence rate was high. Primary success of ECV did not affect the rate of mortality. Pretreatment and delivered energy were not associated with the primary success of ECV.

trial registrationUMIN clinical trial registry, the Japanese clinical trial registry (registration number: UMIN000026401 , March 31, 2017).

Indexed as

Electrical cardioversionMortalityNew-onset atrial fibrillationRhythm control strategy

Identifiers

PMID34238390
PMCPMC8268199
OpenAlexW3181935867

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.