CJEM Visual Abstract – Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergency department

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Welcome back to the 2024 CJEM year! In this issue, we collaborated with the CJEM team to present “Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergency department” in a visual abstract format​1​.

Electrical cardioversion (ECV) is extremely common in the emergency department for paroxysmal atrial rhythms. These patients are often treated with beta- or calcium-channel blockers, both at home and in the ED. Little is known about how their use relates to the risk of hypotension (already established as an important adverse event for ECH for atrial rhythms). At the same time, the risk of respiratory events is on everyone’s mind. This is for both for anecdotal reasons, but also because evidence also backs this is an adverse effect in ECV to be aware of.

In this study by Liu et al., factors associated with hypotension and respiratory events were retrospectively evaluated. Fentanyl use and at-home beta-blocker use were associated with significant rates of hypotension. Older age and midazolam use (for sedation) were associated with unwanted respiratory events. Many other factors were examined.

For a summary of significant factors found to influence each, take a look at the .pdf of the CJEM Visual Abstract attached on the topic below:

CJEM visual abstract
http://canadiem.org/wp-content/uploads/2024/03/cjem-va-feb24-a_63287687.pdf
  1. 1.
    Liu S, Stiell I, Eagles D, Borgundvaag B, Grewal K. Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergency department. Can J Emerg Med. Published online November 25, 2023:103-110. doi:10.1007/s43678-023-00621-z

Samuel Wilson

Sam is a third-year Emergency Medicine FRCPC resident at The Ottawa Hospital. He is the CanadiEM/CJEM Infographic editor, interested in PoCUS, trauma, knowledge dissemination, and all things chess.