Abstract | OBJECTIVE: DESIGN: Prospective study, case series. SETTING: University hospital. PATIENTS: INTERVENTIONS: MAIN OUTCOME MEASURE: Maintenance of sinus rhythm. RESULTS: Mean (SD) follow up was 3.5 (1.7) years. The first cardioversion was successful in 48 patients (96%). After a single shock and without antiarrhythmic drugs being used, 42% of the patients maintained sinus rhythm in the long-term. Only left atrial size was inversely related to the efficacy of one shock (P = 0.025). With serial cardioversion 90% of the patients were kept in sinus rhythm for 5 years. Univariate analysis showed that a long duration of arrhythmia and impaired cardiac function were both related to poor outcome. During follow up 3 patients died of progression of heart failure and another 5 died suddenly. None of these 5 patients was on antiarrhythmic drugs. CONCLUSIONS:
Electrical cardioversion was an effective and safe method of converting chronic atrial flutter to sinus rhythm. To maintain sinus rhythm, more than half of the patients required multiple shocks and prophylactic antiarrhythmic drugs. Sudden death was relatively frequent in the study population; the limited data available from this study suggest that such deaths were caused by the underlying disease and not drug related proarrhythmia.
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Authors | H J Crijns, I C Van Gelder, R G Tieleman, J Brügemann, P J De Kam, A T Gosselink, M T Bink-Boelkens, K I Lie |
Journal | Heart (British Cardiac Society)
(Heart)
Vol. 77
Issue 1
Pg. 56-61
(Jan 1997)
ISSN: 1355-6037 [Print] England |
PMID | 9038696
(Publication Type: Journal Article)
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Topics |
- Atrial Flutter
(therapy)
- Chronic Disease
- Electric Countershock
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Prospective Studies
- Regression Analysis
- Treatment Outcome
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