TY - JOUR
TI - Predictors of atrial fibrillation recurrence in patients with
long-lasting atrial fibrillation
AU - Efremidis, Michalis
AU - Alexanian, Ioannis P.
AU - Oikonomou, Dimitrios
AU - and Manolatos, Dimitrios
AU - Letsas, Konstantinos P.
AU - Pappas, Loukas
AU - K.
AU - Gavrielatos, Gerasimos
AU - Vadiaka, Maria
AU - Mihas, Constantinos
AU - C.
AU - Filippatos, Gerasimos S.
AU - Sideris, Antonios
AU - Kardaras,
AU - Fotios
JO - Canadian Journal of Cardiology
PY - 2009
VL - 25
TODO - 4
SP - E119-E124
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 0828-282X
TODO - 10.1016/S0828-282X(09)70070-4
TODO - Atrial fibrillation; Internal cardioversion; Outcome; Prediction;
Recurrence
TODO - 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.
ER -