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Perceived heart rhythm in relation to ECG findings after direct current cardioversion of atrial fibrillation

A Nergårdh1, M Frick

  • 1Department of Cardiology, Stockholm South Hospital, S-118 83 Stockholm, Sweden. anna.nergardh@sodersjukhuset.se

Heart (British Cardiac Society)
|March 21, 2006
PubMed

Insights

Patients

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia.
  • Direct current (DC) cardioversion aims to restore normal heart rhythm.
  • Patient perception of heart rhythm and symptoms post-cardioversion is important.

Purpose of the Study:

  • To assess agreement between patient-perceived heart rhythm and ECG-registered rhythm after DC cardioversion for AF.
  • To evaluate the correlation between perceived symptoms and ECG findings post-cardioversion.

Main Methods:

  • 356 patients with symptomatic AF undergoing DC cardioversion were interviewed one week post-procedure.
  • Patients reported perceived heart rhythm and symptoms.
  • ECG was performed, and Cohen's kappa test calculated agreement.

Main Results:

  • Agreement between perceived and ECG-registered sinus rhythm (SR) was fair (kappa = 0.34).
  • Agreement between perceived and ECG-registered AF was poor (kappa = 0.13).
  • Symptom improvement agreement with ECG-SR was fair (kappa = 0.26), strongly associated with perceived SR.

Conclusions:

  • Post-cardioversion agreement between perceived and actual heart rhythm is poor to fair.
  • Symptom improvement perception aligns moderately with ECG findings.
  • Objective criteria are needed for rhythm control selection; patient perception of rhythm warrants further study.
Abstract

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