Effect of atrial fibrillation duration on probability of immediate recurrence after transthoracic cardioversion.

Abstract

INTRODUCTION:

An immediate recurrence of atrial fibrillation (IRAF) appears to be more common after early restoration of sinus rhythm with an implantable atrial defibrillator than after elective transthoracic cardioversion, which suggests that the probability of IRAF may be related to the duration of AF.

METHODS AND RESULTS:

Transthoracic cardioversion was performed 85 +/- 187 days (range 7 minutes to 8 years) after the onset of atrial fibrillation in 315 patients (mean age 61 +/- 13 years). IRAF was defined as a recurrence of AF within 60 seconds after restoration of sinus rhythm. IRAF occurred in 56% of patients when cardioversion was performed within 1 hour of the onset of AF compared with 12% of patients when cardioversion was performed after 24 hours of AF (P < 0.001). The duration of AF was the only independent predictor of IRAF among the clinical variables of age, gender, structural heart disease, antiarrhythmic drug therapy, and cardioversion energy (P < 0.01).

CONCLUSION:

IRAF is more likely to occur when the duration of AF is <1 hour than when the duration is >24 hours. This observation has clinical implications for the most appropriate timing of cardioversion, particularly in patients who receive device therapy for AF.

• Authors: Hakan Oral, Mehmet Ozaydin, Christian Sticherling, Hiroshi Tada, Christoph Scharf, Aman Chugh, Steve W K Lai, Frank Pelosi Jr, Bradley P Knight, S Adam Strickberger, Fred Morady
• Journal: Journal of cardiovascular electrophysiology (J Cardiovasc Electrophysiol) Vol. 14 Issue 2 Pg. 182-5 (Feb 2003) ISSN: 1045-3873 [Print] United States
• PMID: 12693502 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Atrial Fibrillation (diagnosis, epidemiology, therapy)
• Electric Countershock (methods)
• Electrocardiography
• Follow-Up Studies
• Humans
• Middle Aged
• Predictive Value of Tests
• Recurrence
• Statistics as Topic
• Treatment Failure
• United States (epidemiology)