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Prediction of cardiac rhythm 1 year following cardioversion for atrial fibrillation

Amjad K Hamid1, A Mark Richards, Ian G Crozier

  • 1Department of Medicine, Otago University-Christchurch, Christchurch, New Zealand. amjadh@cdhb.govt.nz

The New Zealand Medical Journal
|October 4, 2011
PubMed

Insights

Immediate cardioversion (CV) for atrial fibrillation (AF) offers better sinus rhythm (SR) outcomes than elective CV. The number of shocks needed is a new predictor of long-term SR success after AF CV.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Limited recent data exists on cardioversion outcomes for atrial fibrillation (AF) or flutter.
  • Predicting cardiac rhythm success after cardioversion is crucial for patient management.

Purpose of the Study:

  • To evaluate cardiac rhythm outcomes following elective and immediate cardioversion for AF or flutter.
  • To identify predictors of maintaining sinus rhythm (SR) post-cardioversion.

Main Methods:

  • A single-center study documented rhythm at 6 weeks and 12 months post-cardioversion.
  • Included 496 patients undergoing elective cardioversion (EC) and 52 undergoing immediate cardioversion (IC).

Main Results:

  • Immediate cardioversion (IC) patients had higher SR rates (65% at 6 weeks, 58% at 1 year) compared to elective cardioversion (EC) patients (43% and 30%).
  • Amiodarone therapy and atrial flutter were positive predictors of SR at 6 weeks.
  • Multiple shocks and longer arrhythmia duration predicted lower SR success at both 6 weeks and 1 year.

Conclusions:

  • The number of shocks required to achieve SR is a novel, independent predictor of rhythm outcome after elective cardioversion.
  • Immediate cardioversion demonstrates superior short- and long-term rhythm control compared to elective cardioversion.
Abstract

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