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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Arrhythmic complications after electrical cardioversion of acute atrial fibrillation: the FinCV study

Toni Grönberg1, Ilpo Nuotio, Marko Nikkinen

  • 1Heart Center, Turku University Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|May 21, 2013
PubMed

Insights

Bradycardic complications following electrical cardioversion for acute atrial fibrillation (AF) are rare and typically benign. However, older age, female sex, and unsuccessful cardioversion increase the risk, sometimes necessitating permanent pacemaker implantation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) is a common arrhythmia requiring treatment.
  • Electrical cardioversion is a standard procedure for acute AF.
  • Arrhythmic complications, particularly bradycardia, can occur post-cardioversion.

Purpose of the Study:

  • To determine the incidence of arrhythmic complications after electrical cardioversion of acute AF.
  • To identify risk factors associated with these complications.
  • To assess the need for permanent pacemaker implantation following bradycardic events.

Main Methods:

  • Retrospective multicenter study analyzing 7660 cardioversions of acute AF (<48 hours).
  • Data collected from 3143 consecutive patients.
  • Evaluation of immediate arrhythmic complications and predictors.

Main Results:

  • Bradyarrhythmia occurred in 0.9% of cardioversions (63 cases).
  • Asystole was observed in 51 instances, with 2 requiring extrinsic pacing.
  • Independent predictors of bradycardic complications included older age, female sex, and unsuccessful cardioversion.

Conclusions:

  • Bradycardic complications are infrequent and generally benign after acute AF cardioversion.
  • These events may indicate underlying sinus node dysfunction.
  • A significant proportion of patients experiencing bradycardia ultimately require permanent pacemaker implantation.
Abstract

Keywords:
Arrhythmic complicationAtrial fibrillationBradycardiaCardioversion

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