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Cardioversion of atrial fibrillation: how important is a long arrhythmia duration?
Insights
Long-standing atrial fibrillation (AF) is often a barrier to successful cardioversion. However, this report shows that even with AF present for years, successful cardioversion to sinus rhythm is achievable with proper patient selection.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Long duration of atrial fibrillation (AF) is typically viewed as a negative predictor for successful cardioversion.
- Patients with prolonged AF are frequently excluded from cardioversion procedures.
Abstract:
A long duration of atrial fibrillation is usually considered as an adverse feature for successful cardioversion of atrial fibrillation and the maintenance of sinus rhythm. This often leads to the exclusion of such patients from being considered for this procedure. We report three patients in whom atrial fibrillation was present for a long duration (one for 2 years, two for 10 years), and successful cardioversion to sinus rhythm was achieved. Proper selection of patients with atrial fibrillation with an understanding of all features predicting a successful outcome will often allow a good result.