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. 2009 Dec 12:2:39.
doi: 10.1186/1755-7682-2-39.

Short-term and long-term success of electrical cardioversion in atrial fibrillation in managed care system

Suman S Kuppahally  1 , Elyse Foster, Stanford Shoor, Anthony E Steimle
Affiliations

Short-term and long-term success of electrical cardioversion in atrial fibrillation in managed care system

Suman S Kuppahally et al. Int Arch Med. .

Abstract

Background: Initial success of electrical cardioversion (ECV) of atrial fibrillation (AF) has been reported in several studies as 50%-90%, of which only 50% patients remain in sinus rhythm (SR) at the end of one year. We conducted this study to see if outcomes of other trials are applicable in managed care setting.

Methods: We conducted a retrospective study in 370 consecutive patients who underwent ECV for AF. They were reviewed for initial outcome of ECV and recurrence of AF after a successful ECV, with and without prophylactic antiarrhythmic drugs.

Results: Initial success of ECV for AF was 65.7%. At one year, 47% remained in SR. AF for </= 3 months (p = 0.006) and pretreatment with antiarrhythmic drugs (p = 0.032) resulted in improved success. Predictors of recurrence were patients </= 65 years (p = 0.019), paroxysmal atrial fibrillation (PAF) (p = 0.0094) and alcohol consumption (p = 0.0074).

Conclusion: Shorter duration of AF, prophylactic antiarrhythmic drugs and serial ECVs improve outcome of ECV in AF. For younger patients with PAF and alcohol consumption, due to higher recurrence of AF, rate control or ablative therapy may be the preferred strategy.

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Figures

Figure 1
Figure 1
Results of serial electrical cardioversion in atrial fibrillation and follow-up over one year. (ECV-Electrical cardioversion, AF-atrial fibrillation).
Figure 2
Figure 2
Results of serial electrical cardioversion in atrial fibrillation in patients after prophylactic antiarrhythmic drugs and follow-up over one year. (ECV-Electrical cardioversion, AF- atrial fibrillation).
Figure 3
Figure 3
Effect of duration on the success of electrical cardioversion in atrial fibrillation.
See this image and copyright information in PMC

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References

    1. Van Gelder IC, Crijns HJ, Van Gilst WH. Prediction of uneventful cardioversion and maintenance of sinus rhythm from direct-current electrical cardioversion of chronic atrial fibrillation and flutter. Am J Cardiol. 1991;68(1):41–6. doi: 10.1016/0002-9149(91)90707-R. - DOI - PubMed
    1. Van Gelder IC, Crijns HJ, Tieleman RG. Chronic atrial fibrillation. Success of serial cardioversion therapy and safety of oral anticoagulation. Arch Intern Med. 1996;156(22):2585–92. doi: 10.1001/archinte.156.22.2585. - DOI - PubMed
    1. Coplen SE, Antman EM, Berlin JA. Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials. Circulation. 1990;82(4):1106–16. - PubMed
    1. Pritchett EL. Management of atrial fibrillation. N Engl J Med. 1992;326(19):1264–71. - PubMed
    1. Suttorp MJ, Kingma JH, Koomen EM. Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricular function. Am J Cardiol. 1993;71(8):710–3. doi: 10.1016/0002-9149(93)91015-A. - DOI - PubMed