J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://www.jcgo.org

Original Article

Volume 12, Number 2, August 2023, pages 39-45

Outcomes of Cardioversion During Pregnancy: A Retrospective Analysis of the National Inpatient Sample

**Table 1.** Demographics of Patients Undergoing Cardioversion in Pregnancy
Characteristic	Cardioversion (n = 299)	No cardioversion (n = 10,044)	P
SD: standard deviation.
Age, years, mean (SD)	31.6 (6.4)	30.8 (7.1)	0.33
Race, n (%)			0.28
White	128 (49.1)	5,091 (57.3)
Black	84 (32.2)	1,928 (21.7)
Hispanic	35 (13.5)	1,113 (12.5)
Other	14 (5.2)	757 (8.5)
Insurance type, n (%)			0.48
Public (Medicare/Medicaid)	96 (32.1)	3,970 (39.5)
Private	179 (59.8)	5,254 (52.4)
Other	24 (8.1)	809 (8.1)
Hospital region, n (%)			0.09
Northeast	62 (20.7)	2,119 (21.1)
Midwest	44 (14.8)	2,194 (21.8)
South	93 (31.2)	3,689 (36.7)
West	99 (33.3)	2,042 (20.3)
Hospital type, n (%)			< 0.001
Rural	35 (11.7)	981 (9.8)
Urban nonteaching	35 (11.7)	3,047 (30.4)
Urban teaching	229 (76.7)	5,998 (59.8)

Table 1. Demographics of Patients Undergoing Cardioversion in Pregnancy

Characteristic

Cardioversion (n = 299)

No cardioversion (n = 10,044)

SD: standard deviation.

Age, years, mean (SD)

31.6 (6.4)

30.8 (7.1)

0.33

Race, n (%)

0.28

White

128 (49.1)

5,091 (57.3)

Black

84 (32.2)

1,928 (21.7)

Hispanic

35 (13.5)

1,113 (12.5)

Other

14 (5.2)

757 (8.5)

Insurance type, n (%)

0.48

Public (Medicare/Medicaid)

96 (32.1)

3,970 (39.5)

Private

179 (59.8)

5,254 (52.4)

Other

24 (8.1)

809 (8.1)

Hospital region, n (%)

0.09

Northeast

62 (20.7)

2,119 (21.1)

Midwest

44 (14.8)

2,194 (21.8)

South

93 (31.2)

3,689 (36.7)

West

99 (33.3)

2,042 (20.3)

Hospital type, n (%)

< 0.001

Rural

35 (11.7)

981 (9.8)

Urban nonteaching

35 (11.7)

3,047 (30.4)

Urban teaching

229 (76.7)

5,998 (59.8)

**Table 2.** Health Characteristics and Outcomes in Patients Undergoing Cardioversion During Pregnancy
Health characteristic/outcome, n (%), unless otherwise noted	Cardioversion (n = 299)	No cardioversion (n = 10,044)	P
^aCell count is censored according to NIS guidelines (i.e., cell count ≤ 10). IQR: interquartile range; CVD: cardiovascular disease.
Length of stay, days, median (IQR)	3 (1, 4)	2 (1, 4)	0.71
Total charges, thousands of dollars, median (IQR)	16.6 (11.7, 36.7)	12.6 (5.3, 25.1)	< 0.001
Death	20 (6.7)	198 (2.0)	0.01
Preterm labor	-^a	495 (4.9)	0.58
Precipitate labor	0 (0)	20 (0.2)	0.73
C-section	0 (0)	90 (0.9)	0.45
Pacemaker implant	-^a	16 (0.2)	0.01
Acute myocardial infarction	-^a	43 (0.4)	0.004
Major bleeding	-^a	498 (5.0)	0.57
Vascular complication	0 (0)	13 (0.1)	0.74
Acute kidney injury	0 (0)	120 (1.2)	0.40
Thromboembolism	0 (0)	20 (02)	0.73
Ventricular fibrillation	19 (6.4)	59 (0.6)	< 0.001
Ventricular flutter	0 (0)	0 (0)	-
Supraventricular tachycardia	70 (23.5)	2,295 (22.8)	0.91
Ventricular tachycardia	39 (13.0)	623 (6.2)	0.03
Paroxysmal tachycardia	0 (0)	78 (0.8)	0.49
Atrial fibrillation	100 (33.4)	1,285 (12.8)	< 0.001
Atrial flutter	51 (16.9)	184 (1.8)	< 0.001
Cardiac arrest	39 (13.0)	258 (2.6)	< 0.001
Presence of cardiac resynchronization therapy	-^a	144 (1.4)	0.88
Pre-existing CVD	90 (30.1)	1,600 (15.9)	0.004
Ischemic cardiomyopathy	0 (0)	25 (0.2)	0.70
Peripartum cardiomyopathy	0 (0)	65 (0.7)	0.53
Ventricular hypertrophy	0 (0)	41 (0.4)	0.63
Cardiovascular collapse	0 (0)	405 (4.0)	0.11
Cardiogenic shock	-^a	35 (0.3)	0.10
Hypertrophic subaortic stenosis	0 (0)	-^a	0.86
Non-rheumatic valve disorders	21 (6.9)	594 (5.9)	0.75
Endocarditis	0 (0)	11 (0.1)	0.81
Valve disease	-^a	132 (1.3)	0.17
Presence of prosthetic valve	13 (4.5)	36 (0.4)	< 0.001
Congenital abnormalities of the heart	20 (6.6)	139 (1.4)	0.001
Pulmonary artery stenosis	0 (0)	20 (0.2)	0.73
Mild to moderate pre-eclampsia	0 (0)	129 (1.3)	0.37
Severe pre-eclampsia	-^a	120 (1.2)	0.74
Pre-existing hypertension with pre-eclampsia	0 (0)	115 (1.1)	0.41
Transient cerebral ischemic attack	0 (0)	15 (0.1)	0.77
Multiple gestation	-^a	235 (2.3)	0.61
Thyroid gland disorder	0 (0)	34 (0.3)	0.65
Hypothyroidism	15 (5.0)	369 (3.7)	0.59
Thyrotoxicosis/hyperthyroidism	-^a	120 (1.2)	0.74
Diabetes mellitus	20 (6.7)	712 (7.1)	0.91
Gestational diabetes mellitus	15 (5.0)	261 (2.6)	0.25
Premature separation of placenta	-^a	85 (0.8)	0.50
Blood clotting disorder	-^a	147 (1.5)	0.89

Table 2. Health Characteristics and Outcomes in Patients Undergoing Cardioversion During Pregnancy

Health characteristic/outcome, n (%), unless otherwise noted

Cardioversion (n = 299)

No cardioversion (n = 10,044)

^aCell count is censored according to NIS guidelines (i.e., cell count ≤ 10). IQR: interquartile range; CVD: cardiovascular disease.

Length of stay, days, median (IQR)

3 (1, 4)

2 (1, 4)

0.71

Total charges, thousands of dollars, median (IQR)

16.6 (11.7, 36.7)

12.6 (5.3, 25.1)

< 0.001

Death

20 (6.7)

198 (2.0)

0.01

Preterm labor

-^a

495 (4.9)

0.58

Precipitate labor

0 (0)

20 (0.2)

0.73

C-section

0 (0)

90 (0.9)

0.45

Pacemaker implant

-^a

16 (0.2)

0.01

Acute myocardial infarction

-^a

43 (0.4)

0.004

Major bleeding

-^a

498 (5.0)

0.57

Vascular complication

0 (0)

13 (0.1)

0.74

Acute kidney injury

0 (0)

120 (1.2)

0.40

Thromboembolism

0 (0)

20 (02)

0.73

Ventricular fibrillation

19 (6.4)

59 (0.6)

< 0.001

Ventricular flutter

0 (0)

Supraventricular tachycardia

70 (23.5)

2,295 (22.8)

0.91

Ventricular tachycardia

39 (13.0)

623 (6.2)

0.03

Paroxysmal tachycardia

0 (0)

78 (0.8)

0.49

Atrial fibrillation

100 (33.4)

1,285 (12.8)

< 0.001

Atrial flutter

51 (16.9)

184 (1.8)

< 0.001

Cardiac arrest

39 (13.0)

258 (2.6)

< 0.001

Presence of cardiac resynchronization therapy

-^a

144 (1.4)

0.88

Pre-existing CVD

90 (30.1)

1,600 (15.9)

0.004

Ischemic cardiomyopathy

0 (0)

25 (0.2)

0.70

Peripartum cardiomyopathy

0 (0)

65 (0.7)

0.53

Ventricular hypertrophy

0 (0)

41 (0.4)

0.63

Cardiovascular collapse

0 (0)

405 (4.0)

0.11

Cardiogenic shock

-^a

35 (0.3)

0.10

Hypertrophic subaortic stenosis

0 (0)

-^a

0.86

Non-rheumatic valve disorders

21 (6.9)

594 (5.9)

0.75

Endocarditis

0 (0)

11 (0.1)

0.81

Valve disease

-^a

132 (1.3)

0.17

Presence of prosthetic valve

13 (4.5)

36 (0.4)

< 0.001

Congenital abnormalities of the heart

20 (6.6)

139 (1.4)

0.001

Pulmonary artery stenosis

0 (0)

20 (0.2)

0.73

Mild to moderate pre-eclampsia

0 (0)

129 (1.3)

0.37

Severe pre-eclampsia

-^a

120 (1.2)

0.74

Pre-existing hypertension with pre-eclampsia

0 (0)

115 (1.1)

0.41

Transient cerebral ischemic attack

0 (0)

15 (0.1)

0.77

Multiple gestation

-^a

235 (2.3)

0.61

Thyroid gland disorder

0 (0)

34 (0.3)

0.65

Hypothyroidism

15 (5.0)

369 (3.7)

0.59

Thyrotoxicosis/hyperthyroidism

-^a

120 (1.2)

0.74

Diabetes mellitus

20 (6.7)

712 (7.1)

0.91

Gestational diabetes mellitus

15 (5.0)

261 (2.6)

0.25

Premature separation of placenta

-^a

85 (0.8)

0.50

Blood clotting disorder

-^a

147 (1.5)

0.89

**Table 3.** Distribution of Health Characteristics Undergoing Cardioversion During Pregnancy After Applying Propensity Score Weights
Health characteristic/outcome, n (%), unless otherwise noted	Cardioversion (n = 9,468)	No cardioversion (n = 10,346)	P
CVD: cardiovascular disease.
Ventricular fibrillation	59 (0.6)	74 (0.7)	0.83
Ventricular tachycardia	681 (7.2)	665 (6.4)	0.81
Atrial fibrillation	1,550 (16.4)	1,389 (13.4)	0.48
Atrial flutter	295 (3.1)	231 (2.2)	0.44
Cardiac arrest	306 (3.2)	292 (2.8)	0.77
Pre-existing CVD	2,025 (21.4)	1,691 (16.3)	0.36
Presence of prosthetic valve	80 (0.8)	54 (0.5)	0.56
Congenital abnormalities of the heart	90 (1.0)	167 (1.6)	0.34

Table 3. Distribution of Health Characteristics Undergoing Cardioversion During Pregnancy After Applying Propensity Score Weights

Health characteristic/outcome, n (%), unless otherwise noted

Cardioversion (n = 9,468)

No cardioversion (n = 10,346)

CVD: cardiovascular disease.

Ventricular fibrillation

59 (0.6)

74 (0.7)

0.83

Ventricular tachycardia

681 (7.2)

665 (6.4)

0.81

Atrial fibrillation

1,550 (16.4)

1,389 (13.4)

0.48

Atrial flutter

295 (3.1)

231 (2.2)

0.44

Cardiac arrest

306 (3.2)

292 (2.8)

0.77

Pre-existing CVD

2,025 (21.4)

1,691 (16.3)

0.36

Presence of prosthetic valve

80 (0.8)

54 (0.5)

0.56

Congenital abnormalities of the heart

90 (1.0)

167 (1.6)

0.34

**Table 4.** Propensity Score Weighted Differences in Outcomes Between Those Who Did and Did Not Undergo Cardioversion
Outcome	Mean difference/OR	95% CI	P
OR: odds ratio; CI: confidence interval.
Total charges, thousands of dollars	1.58	1.11	2.24	0.01
Death	6.40	1.95	20.96	0.002
Pacemaker implant	0.35	0.04	3.45	0.37
Acute myocardial infarction	5.18	0.79	33.99	0.09

Table 4. Propensity Score Weighted Differences in Outcomes Between Those Who Did and Did Not Undergo Cardioversion

Outcome

Mean difference/OR

95% CI

Lower bound

Upper bound

OR: odds ratio; CI: confidence interval.

Total charges, thousands of dollars

1.58

1.11

2.24

0.01

Death

6.40

1.95

20.96

0.002

Pacemaker implant

0.35

0.04

3.45

0.37

Acute myocardial infarction

5.18

0.79

33.99

0.09