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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Short-term and long-term success of electrical cardioversion in atrial fibrillation in managed care system

Suman S Kuppahally1, Elyse Foster, Stanford Shoor

  • 1Division of Cardiology, University of Utah, 50 North Medical Drive, Salt Lake City, UT, 84132, USA. sumans@yahoo.com.

International Archives of Medicine
|December 17, 2009
PubMed

Insights

Electrical cardioversion (ECV) for atrial fibrillation (AF) shows initial success but high recurrence. Shorter AF duration and antiarrhythmic drugs improve outcomes, while younger patients with paroxysmal AF and alcohol use may benefit from alternative strategies.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Electrical cardioversion (ECV) for atrial fibrillation (AF) has variable success rates, with only 50% of patients maintaining sinus rhythm (SR) one year post-procedure.
  • Managed care settings may present unique challenges and outcomes for ECV in AF patients.

Purpose of the Study:

  • To evaluate the effectiveness and recurrence rates of ECV for AF within a managed care population.
  • To identify factors influencing the long-term success of ECV in maintaining SR.

Main Methods:

  • A retrospective study of 370 consecutive patients undergoing ECV for AF.
  • Analysis of initial ECV success and AF recurrence rates, considering prophylactic antiarrhythmic drug use.

Main Results:

  • Initial ECV success rate was 65.7%, with 47% of patients remaining in SR at one year.
  • Shorter AF duration (≤3 months) and pretreatment with antiarrhythmic drugs significantly improved ECV success.
  • Recurrence predictors included younger age (≤65 years), paroxysmal atrial fibrillation (PAF), and alcohol consumption.

Conclusions:

  • Shorter AF duration, prophylactic antiarrhythmic drugs, and serial ECVs enhance ECV outcomes.
  • For younger patients with PAF and alcohol consumption, alternative strategies like rate control or ablative therapy are recommended due to higher AF recurrence rates.
Abstract

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