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Long-term outcome in patients with chronic atrial fibrillation after successful internal cardioversion
1Department of Medicine, University of Hong Kong, Queen Mary Hospital, China.
Insights
Internal cardioversion safely restores sinus rhythm in persistent atrial fibrillation (AF). Class III antiarrhythmic drugs, particularly amiodarone, help maintain sinus rhythm in over 40% of patients with long-standing AF.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Atrial fibrillation (AF) is a common arrhythmia.
- Persistent AF, especially of prolonged duration, presents treatment challenges.
- Restoring and maintaining sinus rhythm is a key therapeutic goal.
Purpose of the Study:
- To evaluate the safety and efficacy of internal cardioversion in patients with persistent AF.
- To assess the effectiveness of antiarrhythmic drugs in maintaining sinus rhythm post-cardioversion.
- To compare amiodarone and sotalol in patients with AF lasting 1-3 years.
Main Methods:
- Internal cardioversion procedure.
- Administration of Class III antiarrhythmic drugs (amiodarone and sotalol).
- Follow-up assessment of sinus rhythm maintenance.
Main Results:
- Internal cardioversion is safe and effective for restoring sinus rhythm, even in persistent AF.
- 40-50% of patients with AF >1 year but <3 years maintained sinus rhythm post-cardioversion with antiarrhythmic drugs.
- Amiodarone demonstrated greater efficacy than sotalol in this patient group.
Conclusions:
- Internal cardioversion is a viable strategy for managing persistent AF.
- Antiarrhythmic drug therapy is crucial for maintaining sinus rhythm after cardioversion.
- Amiodarone is a preferred agent over sotalol for long-term rhythm control in selected AF patients.
Abstract:
Internal cardioversion is safe and effective in restoring sinus rhythm, even in patients with persistent AF of prolonged duration. Up to 40% to 50% of patients with AF lasting >1 year but <3 years could be maintained in sinus rhythm using a class III antiarrhythmic drug after successful internal cardioversion, and amiodarone appears to be more effective than sotalol in this patient population.