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Electrical cardioversion for early recurrences post pulmonary vein isolation.

Gesa von Olshausen1, Astrid Paul-Nordin2, Jari Tapanainen2

  • 1Department of Cardiology, Karolinska University Hospital, Solna, S1:02, 17176, Stockholm, Sweden. gesa.von.olshausen@ki.se.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|September 9, 2022
PubMed
Summary

Failed electrical cardioversion (ECV) and delayed ECV (>7 days from early recurrence onset) are linked to late recurrences after atrial fibrillation ablation. Prompt ECV is crucial for better long-term rhythm outcomes.

Keywords:
Atrial fibrillationCatheter ablationEarly recurrenceElectrical cardioversionLate recurrence

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) ablation aims for long-term rhythm control.
  • Early recurrences (ERs) of AF post pulmonary vein isolation (PVI) are common.
  • Electrical cardioversion (ECV) is used to treat ERs.

Purpose of the Study:

  • To investigate the association between ECV timing and success.
  • To determine the impact of ECV on long-term rhythm outcomes after PVI.
  • To identify factors associated with ECV failure and late recurrences (LRs).

Main Methods:

  • Retrospective analysis of 133 patients undergoing ECV for ERs post AF ablation.
  • Patients were monitored for 1-year for late recurrences (LRs).
  • Statistical analysis identified predictors of ECV failure and LRs.

Main Results:

  • ECV success rate was 85.7%.
  • Higher BMI, lower ejection fraction, and delayed ECV (>7 days) predicted ECV failure.
  • Failed ECV and delayed ECV were significantly associated with higher rates of LRs.

Conclusions:

  • Failed ECV independently predicts late recurrences.
  • Performing ECV more than 7 days after ER onset is associated with increased risk of LRs.
  • Timely ECV is important for achieving successful long-term rhythm control post-PVI.