van Vliet Risco, van Eck Martijn, Wieringa Wouter G, Moors Xavier R J, Van't Hof Arnoud W J
Regional Emergency Medical Services, RAV Brabant Midden-West-Noord, 's-Hertogenbosch, the Netherlands.
Cardiovascular Research Institute Maastricht (CARIM), the Netherlands.
Eur J Cardiovasc Nurs. 2025 Jul 17. doi: 10.1093/eurjcn/zvaf140.
Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide. Cardioversion for AF is indicated to improve symptoms and haemodynamic status. Patients with persistent AF requiring direct current electrical cardioversion (DC-ECV) present a significant challenge to the cardiology department. Hospital at Home represents a paradigm shift in the standard way of delivering acute care. Encouraged by these possibilities and benefits, the cardiology department of the Jeroen Bosch Hospital and the local emergency medical service RAV Brabant MWN raised the question of whether DC-ECV treatment can be carried out at home instead of in an inpatient setting. This pilot study aims to investigate whether home-based cardioversion is feasible.
ELECTRA-1 is a single-centre, prospective feasibility study of home-based ECV in haemodynamically stable AF patients requiring cardioversion. The APP-led home-based DC-ECV was carried out by advanced practice providers (APPs) of the emergency medical service RAV Brabant MWN supported by an ambulance team consisting of an ambulance nurse and driver both trained in advanced live support. Thirty-eight patients gave their consent, and 26 (68%) had a home DC-ECV. In 23 (88%) cases, the DC-ECV was successful, and sinus rhythm was achieved. Twelve (32%) cases had a spontaneous return to sinus rhythm. No early or late major adverse cardiovascular and cerebrovascular event was reported for these 26 patients.
Performing DC-ECV at home is feasible. This study did not examine the safety of doing so but did find a high level of satisfaction among the participating patients.
ClinicalTrials.gov ID NCT06322836.
心房颤动（AF）是全球最常见的持续性心律失常。房颤复律旨在改善症状和血流动力学状态。需要直流电心脏复律（DC-ECV）的持续性房颤患者给心脏病科带来了重大挑战。居家医院代表了急性护理标准方式的范式转变。受这些可能性和益处的鼓舞，耶罗恩·博世医院的心脏病科和当地紧急医疗服务机构RAV Brabant MWN提出了一个问题，即DC-ECV治疗是否可以在家中而非住院环境中进行。这项前瞻性研究旨在调查在家中进行心脏复律是否可行。
ELECTRA-1是一项针对需要心脏复律的血流动力学稳定的房颤患者进行的基于家庭的ECV单中心前瞻性可行性研究。由紧急医疗服务机构RAV Brabant MWN的高级执业提供者（APPs）在由一名经过高级生命支持培训的救护车护士和司机组成的救护车团队支持下进行APP主导的基于家庭的DC-ECV。38名患者表示同意，26名（68%）接受了家庭DC-ECV。在23例（88%）中，DC-ECV成功，实现了窦性心律。12例（32%）患者窦性心律自发恢复。这26名患者均未报告早期或晚期重大心脑血管不良事件。
在家中进行DC-ECV是可行的。本研究未检验其安全性，但发现参与患者的满意度较高。
ClinicalTrials.gov标识符NCT06322836
