@article{3141952,
    title = "Predictors of atrial fibrillation recurrence in patients with
long-lasting atrial fibrillation",
    author = "Efremidis, Michalis and Alexanian, Ioannis P. and Oikonomou, Dimitrios and and Manolatos, Dimitrios and Letsas, Konstantinos P. and Pappas, Loukas and K. and Gavrielatos, Gerasimos and Vadiaka, Maria and Mihas, Constantinos and C. and Filippatos, Gerasimos S. and Sideris, Antonios and Kardaras, and Fotios",
    journal = "Canadian Journal of Cardiology",
    year = "2009",
    volume = "25",
    number = "4",
    pages = "E119-E124",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    issn = "0828-282X",
    doi = "10.1016/S0828-282X(09)70070-4",
    keywords = "Atrial fibrillation; Internal cardioversion; Outcome; Prediction;
Recurrence",
    abstract = "BACKGROUND:
Limited data are available on the predictors of atrial fibrillation (AF)
recurrence in patients with chronic AF.OBJECTIVES:
To evaluate potential clinical, echocardiographic and
electrophysiological predictors of AF recurrence after internal
cardioversion for long-lasting AF.METHODS:
A total of 99 consecutive patients (63 men and 36 women, mean age 63.33
+/- 9.27 years) with long-standing AF (52.42 +/- 72.02 months) underwent
internal cardioversion with a catheter that consisted of two
defibrillating coils. Shocks were delivered according to a step-up
protocol. Clinical follow-up and electrocardiographic recordings were
performed on a monthly basis for a 12-month period or whenever patients
experienced symptoms suggestive of recurrent AF.RESULTS:
Ninety-three patients (93.94 %) underwent a successful uncomplicated
cardioversion, with a mean atrial defibrillation threshold of 10.69 +/-
6.76 J. Immediate reinitiation of AF was observed in 15 patients (15.78
%) of whom a repeated cardioversion restored sinus rhythm in 13 cases.
Early recurrence of AF (within one week) was observed in 12 of 93
patients (12.90 %). At the end of the 12-month follow-up period, during
which seven patients were lost, 42 of the 86 remaining patients (48.84
%) were still in sinus rhythm. Multivariate regression analysis showed
that left atrial diameter (OR 1.126, 95 % CI 1.015 to 1.249; P=0.025)
and mitral A wave velocity (OR 0.972, 95 % CI 0.945 to 0.999; P=0.044)
were significant and independent predictors of AF recurrence, whereas
age, left ventricular ejection fraction and AF cycle length were not
predictive of arrhythmia recurrence.CONCLUSION:
The present study showed that the left atrial diameter and mitral A wave
velocity are the only variables associated with AF recurrence after
successful cardioversion."
}