A simple point score system for predicting the efficacy of external rectilinear biphasic cardioversion for persistent atrial fibrillation

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Sebastian StecPiotr Kulakowski

Abstract

To develop a simple point score system that can accurately predict the optimal energy of initial rectilinear biphasic (RLB) waveform shock for cardioversion (DC) of persistent atrial fibrillation (AF). Data from 302 consecutive patients with AF who underwent a step-up protocol of sequential shocks of 50 J-from 1 up to 2 J/kg-200 J of RLB waveform DC were prospectively examined. Using a logistic regression model, three variables independently predicted the need for 2 J/kg shocks: AF duration > 7 months, previous DC, and increased left atrial (LA) diameter > 4.5 cm. A simplified point score system (REBICAF score) that spans from 0 to 4 was developed. The score gives two points for AF duration > 7 months and one point for previous DC or LA diameter > 4.5 cm. The area under the receiver operator curve (ROC) of the proposed score for predicting the need for 2 J/kg shock was 0.84. There was a progressive increase in the need for 1 J/kg, 2 J/kg, and 200 J as the point score increased (P < 0.001, chi2 test for trend). More than 90% cumulative success rate was achieved in the low- (0-1), intermediate- (2), and high-REBICAF (3-4) score subgroups with 1 J/kg, 2 J/kg, and 200 J RLB shocks, respectively. A simple point score system is usefu...Continue Reading

References

Aug 11, 2000·JAMA : the Journal of the American Medical Association·E M AntmanE Braunwald
Aug 15, 1963·The New England Journal of Medicine·B LOWND E HARKEN
Jun 11, 2004·Pacing and Clinical Electrophysiology : PACE·Beata Wozakowska-KaplonRadoslaw Bartkowiak
Jul 21, 2004·International Journal of Cardiology·Beata Wozakowska-Kapłon, Grzegorz Opolski
Aug 31, 2004·Journal of Cardiovascular Electrophysiology·Stephanos SiaplaourasJens Jung

❮ Previous
Next ❯

Citations

Jul 5, 2012·Pacing and Clinical Electrophysiology : PACE·Elisabetta TosoFiorenzo Gaita

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.