Factors predicting success rate and recurrence of atrial fibrillation after first electrical cardioversion in patients with persistent atrial fibrillation

被引:109
|
作者
Frick, M [1 ]
Frykman, V
Jensen-Urstad, M
Östergren, J
Rosenqvist, M
机构
[1] South Hosp, Dept Cardiol, S-11883 Stockholm, Sweden
[2] Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden
[3] Karolinska Hosp, Dept Med, S-10401 Stockholm, Sweden
关键词
atrial fibrillation; cardioversion; arrhythmias;
D O I
10.1002/clc.4960240313
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The recurrence rate of atrial fibrillation (AF) after elective cardioversion is high. Hypothesis: The study aimed to identify clinical predictors for successful electrical cardioversion and maintenance of sinus rhythm after a first electrical cardioversion in patients with persistent AF without concomitant antiarrhythmic drugs of class I and LII. Methods: Consecutive outpatients (n = 166) with persistent AF for > 1 month, scheduled for elective cardioversion, were prospectively included in the study. A clinical investigation, echocardiographic assay, and Kelter electrocardiogram (ECG) before and ECG 4 weeks after cardioversion, were performed in all patients. Results: The mean age of the patients was 68 years (range 45-83) and duration of AF was 5 (1-48) months. Sinus rhythm was established in 124 (75%) patients. In multivariate analysis, only duration of AF < 6 months (p < 0.04, odds ratio [OR] 2.2, 95% confidence interval [CI] 1.1 to 4.7) and patients weight (p <0.03, OR 2.3, 95% CI 1.1 to 4.8 for weight < 80 kg) were identified as independent predictors of successful cardioversion. At 4 weeks after cardioversion, only 46 (37%) of 124 patients maintained sinus rhythm. Independent factors for maintenance of sinus rhythm, in multivariate analysis, were AF <3 months (p<0.04, OR 2.5, 95% CI 1.1 to 5.6), treatment with beta blockers (p < 0.00001, OR 7.0, 95% CI 3.0 to 16.3) or verapamil/diltiazem (p<0.04, OR 3.6, 95% CI 1.1 to 12.1), and right atrial dimension < 37 mm (p < 0.02, OR 5.9, 95% CI 1.4 to 25.4). Conclusions: In patients with persistent AF, the patient's weight and the duration of AF are independent predictors for a successful cardioversion. Short duration of AF, treatment with beta blockers or verapamil/diltiazem, and right atrial area/dimension are independent predictors for maintenance of sinus rhythm.
引用
收藏
页码:238 / 244
页数:7
相关论文
共 50 条
  • [21] Markers of inflammation and recurrence of atrial fibrillation after electrical cardioversion
    Tveit, A.
    Grundvold, I.
    Seljeflot, I.
    Abdelnoor, M.
    Arnesen, H.
    Smith, P.
    EUROPEAN HEART JOURNAL, 2006, 27 : 43 - 43
  • [22] Reversal of electrical remodeling after cardioversion of persistent atrial fibrillation
    Raitt, MH
    Kusumoto, W
    Giraud, G
    McAnulty, JH
    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2004, 15 (05) : 507 - 512
  • [23] Improving first shock success in patients with atrial fibrillation undergoing electrical cardioversion
    Vinson, David R.
    Isaacs, Dayna J.
    Othieno, Alisha A.
    Liu, Taylor I.
    EUROPACE, 2019, 21 (05): : 833 - 833
  • [24] Predictors of success and effect of biphasic energy on electrical cardioversion in patients with persistent atrial fibrillation
    Alegret, Josep M.
    Vinolas, Xavier
    Sagrista, Jaume
    Hernandez-Madrid, Antonio
    Perez, Luisa
    Sabate, Xavier
    Mont, Lluis
    Medina, Alfonso
    EUROPACE, 2007, 9 (10): : 942 - 946
  • [25] THE TIME OF ELECTRICAL CARDIOVERSION IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION WITH HYPERTHYROIDISM
    Erdogan, E.
    Akkaya, M.
    Vatankulu, M. A.
    Bacaksiz, A.
    Goktekin, O.
    INTERNATIONAL JOURNAL OF CARDIOLOGY, 2011, 147 : S117 - S117
  • [26] Optimal timing of electrical cardioversion in patients with persistent atrial fibrillation
    Naji, Franjo
    Vokac, Damijan
    Kanic, Vojko
    Sabovic, Miso
    MEDICAL SCIENCE MONITOR, 2010, 16 (10): : CR464 - CR468
  • [27] Current aspects of electrical cardioversion in patients with persistent atrial fibrillation
    Mickley, F
    Löscher, S
    Hartmann, A
    MEDIZINISCHE KLINIK, 2004, 99 (01) : 18 - 23
  • [28] CRP as a predictor of success of cardioversion for atrial fibrillation and recurrence after conversion
    Watanabe, E
    Arakawa, T
    Uchiyama, T
    Maehara, M
    Inoue, K
    Hiramitsu, S
    Kodama, I
    Hishida, H
    CIRCULATION, 2003, 108 (17) : 708 - 708
  • [29] Analysis of heart rate variability and early recurrence of atrial fibrillation after electrical cardioversion
    Vaiciulyte, R
    Losinskiene, L
    FRONTIERS IN CORONARY ARTERY DISEASE, 2003, : 305 - 307
  • [30] Effect of verapamil on secondary cardioversion in patients with early atrial fibrillation recurrence after electrical cardioversion
    De Simone, A
    Turco, P
    De Matteis, C
    La Rocca, V
    Nocerino, P
    Greco, L
    Astarita, C
    Messina, V
    Rotunno, R
    Iaconelli, G
    Stabile, E
    Stabile, G
    AMERICAN JOURNAL OF CARDIOLOGY, 2002, 90 (02): : 185 - +