Poor maintenance of sinus rhythm after electrical cardioversion of patients with atrial fibrillation or flutter: a 5-year follow-up of 268 consecutive patients

被引:18
作者
Dahlin, J [1 ]
Svendsen, P [1 ]
Gadsboll, N [1 ]
机构
[1] Univ Copenhagen, Bispebjerg Hosp, Dept Cardiovasc Med Y, DK-2400 Copenhagen NV, Denmark
关键词
atrial fibrillation; direct current cardioversion; maintenance sinus rhythm;
D O I
10.1080/14017430310016090
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective - To report long- term results of direct current ( DC)- cardioversion in unselected patients with atrial fibrillation ( AF) or flutter. Design - The study was a retrospective 5- year followup of all patients undergoing DC- cardioversion for AF or flutter at our institution between 1993 and 1997. Results - Three hundred and eighty- five DC- cardioversions were performed in 268 patients. Two hundred and forty- nine patients underwent cardioversion for the first time. Of these, 183 ( 74%) were converted to sinus rhythm. During the first month of follow- up 105 ( 57%) relapsed into AF. Only 33 patients ( 13%) of the 249 patients scheduled for cardioversion remained in sinus rhythm after 1 year. In multivariate analysis arrhythmia duration was the only variable that was associated with successful cardioversion. Periprocedural complications occurred in 9.9% of the cardioversions. Conclusion - In daily routine only a minority of patients will maintain sinus rhythm after DC- cardioversion for AF or flutter. Also, DC- cardioversion is not without risk. These observational data suggest a conservative approach to re- establishment of sinus rhythm in patients with AF.
引用
收藏
页码:324 / 328
页数:5
相关论文
共 23 条
[1]   Biphasic waveform cardioversion as an alternative to internal cardioversion for atrial fibrillation refractory to conventional monophasic waveform transthoracic shock [J].
Benditt, DG ;
Samniah, N ;
Iskos, D ;
Lurie, KG ;
Padanilam, BJ ;
Sakaguchi, S .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 88 (12) :1426-+
[2]   Electrical cardioversion for atrial fibrillation: outcomes in 'real-life' clinical practice [J].
Berry, C ;
Stewart, S ;
Payne, EM ;
McArthur, JD ;
McMurray, JJV .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2001, 81 (01) :29-35
[3]   External cardioversion of atrial fibrillation: role of paddle position on technical efficacy and energy requirements [J].
Botto, GL ;
Politi, A ;
Bonini, W ;
Broffoni, T ;
Bonatti, R .
HEART, 1999, 82 (06) :726-730
[4]   FACTORS DETERMINING MAINTENANCE OF SINUS RHYTHM AFTER CHRONIC ATRIAL-FIBRILLATION WITH LEFT ATRIAL DILATATION [J].
BRODSKY, MA ;
ALLEN, BJ ;
CAPPARELLI, EV ;
LUCKETT, CR ;
MORTON, R ;
HENRY, WL .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (15) :1065-1068
[5]   ECHOCARDIOGRAPHIC AND CLINICAL PREDICTORS FOR OUTCOME OF ELECTIVE CARDIOVERSION OF ATRIAL-FIBRILLATION [J].
DITTRICH, HC ;
ERICKSON, JS ;
SCHNEIDERMAN, T ;
BLACKY, AR ;
SAVIDES, T ;
NICOD, PH .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (03) :193-197
[6]   Factors influencing long term persistence of sinus rhythm after a first electrical cardioversion for atrial fibrillation [J].
Duytschaever, M ;
Haerynck, F ;
Tavernier, R ;
Jordaens, L .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1998, 21 (01) :284-287
[7]   OPTIMAL TECHNIQUE FOR ELECTRICAL CARDIOVERSION OF ATRIAL-FIBRILLATION [J].
EWY, GA .
CIRCULATION, 1992, 86 (05) :1645-1647
[8]   Electrical remodeling of the human atrium: Similar effects in patients with chronic atrial fibrillation and atrial flutter [J].
Franz, MR ;
Karasik, PL ;
Li, CL ;
Moubarak, J ;
Chavez, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (07) :1785-1792
[9]   ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation -: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology [J].
Fuster, V ;
Rydén, LE ;
Asinger, RW ;
Cannom, DS ;
Crijns, HJ ;
Frye, RL ;
Halperin, JL ;
Kay, GN ;
Klein, WW ;
Lévy, S ;
McNamara, RL ;
Prystowsky, EN ;
Wann, LS ;
Wyse, DG .
EUROPEAN HEART JOURNAL, 2001, 22 (20) :1852-1923
[10]  
Gentile F, 2002, MAYO CLIN PROC, V77, P897