Electrical cardioversion for persistent or chronic atrial fibrillation: outcome and clinical factors predicting short and long term success rate

International Journal of Cardiology
Miry Blich, Yeouda Edoute

Abstract

To assess the effectiveness and to identify predictors for successful electrical cardioversion (ECV) and maintenance of sinus rhythm, in long term follow up of patients with persistent (PAF) and chronic atrial fibrillation (CAF). Retrospective analysis of medical records of 68 patients with PAF or CAF, who underwent 91 cardioversions. ECV was successful in 86 attempts (94.5%). In obese (body mass index>30) and hypertensive patients (blood pressure >140/90 mm Hg), ECV was less successful in restoring sinus rhythm (p<0.05, p<0.021, respectively). Sinus rhythm was maintained more than half a year in 42 cardioversions (61%). Treatment with beta blockers prior to cardioversion and age younger than 75 were independent factors predicting long term success (p<0.013, p<0.034, respectively). Mild or moderate enlargement of left atrium (<6 cm) did not predict relapse of the arrhythmia. Second ECV was as or more effective than the first in 82.3% of patients that underwent more than one cardioversion. Conversion of atrial fibrillation by DC shock was found to be safe and effective procedure. Patients should be treated with beta blockers prior to cardioversion, if possible. Mild or moderate enlargement of left atrium is not contraindication ...Continue Reading

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Citations

Oct 5, 2013·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·I LimantoroY Blaauw
Jul 21, 2010·International Journal of Clinical Practice·A AryaA N Sulke
Aug 8, 2009·Pacing and Clinical Electrophysiology : PACE·James A Reiffel
Jul 5, 2012·Pacing and Clinical Electrophysiology : PACE·Elisabetta TosoFiorenzo Gaita
Dec 24, 2014·Pacing and Clinical Electrophysiology : PACE·Toni GrönbergK E Juhani Airaksinen
Nov 7, 2015·Journal of Translational Medicine·Eva A H LantersNatasja M S de Groot
May 18, 2007·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·Christos VarounisDennis V Cokkinos

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