{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:29Z","timestamp":1792787309846,"version":"4.5.0"},"reference-count":19,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"unspecified","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K12AR085635"],"award-info":[{"award-number":["K12AR085635"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Danish Cardiovascular Academy","award":["PD2Y-2022002-DCA"],"award-info":[{"award-number":["PD2Y-2022002-DCA"]}],"id":[{"id":"https:\/\/ror.org\/05c0k5d98","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Novo Nordisk Foundation","award":["NNF20SA0067242"],"award-info":[{"award-number":["NNF20SA0067242"]}],"id":[{"id":"https:\/\/ror.org\/04txyc737","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Danish Heart Foundation"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL092577"],"award-info":[{"award-number":["R01HL092577"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2026,7,12]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Electrical cardioversion (ECV) is widely used for restoring sinus rhythm in atrial fibrillation (AF). However, population-level trends in use of ECV in individuals with AF remain poorly characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We examined nationwide temporal trends in ECV utilisation between 2010 and 2022 in Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a registry-based cohort study using Danish nationwide health data. Two cohorts were defined: (1) individuals with prevalent or newly diagnosed AF were used to quantify annual ECV volume. (2) Individuals with newly diagnosed AF were used to calculate unadjusted and age-adjusted and sex-adjusted ECV rates per 1000 person-years during the first year after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The total number of ECVs per year increased almost fourfold between 2010 and 2022 (from 2204 to 8300). The 1-year age-adjusted and sex-adjusted rate of ECVs decreased from 449.5 per 1000 person-years in 2010 to 316.6 per 1000 person-years in 2021. Rates increased among individuals aged \u226575 years but declined among younger patients. When restricted to the first ECV procedure, analyses showed a twofold increase in first-time ECVs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increasing volume of ECVs reflects growing demand for rhythm control, while declining rates may suggest more targeted use of ECV. The findings highlight the need for resource planning and monitoring of procedural burden to support guideline implementation and equitable rhythm control delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2026-004083","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:40:13Z","timestamp":1786711213000},"page":"e004083","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Electrical cardioversion for atrial fibrillation: nationwide trends in Denmark, 2010\u20132022"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9215-9796","authenticated-orcid":false,"given":"Lars","family":"Frost","sequence":"first","affiliation":[{"name":"Department of Cardiology, Regional Hospital Central Jutland, Silkeborg, Denmark"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3338-9297","authenticated-orcid":false,"given":"Tanja Charlotte","family":"Frederiksen","sequence":"additional","affiliation":[{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"},{"name":"Department of Cardiology, Regional Hospital Horsens, Horsens, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Paaske","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"},{"name":"Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine and Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8770-1674","authenticated-orcid":false,"given":"Ole Dyg","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Trinquart","sequence":"additional","affiliation":[{"name":"Tufts Clinical and Translational Science Institute, Tufts University, Boston University, Boston, Massachusetts, USA"},{"name":"Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-8483","authenticated-orcid":false,"given":"Nicklas","family":"Vinter","sequence":"additional","affiliation":[{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026091603502285000_13.2.e004083.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196308152690701"},{"key":"2026091603502285000_13.2.e004083.2","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1093\/europace\/euaa057","article-title":"Cardioversion of atrial fibrillation and atrial flutter revisited: current evidence and practical guidance for a common 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