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Article: Clinical predictors and time course of arrhythmia recurrence in patients with early reinitiation of atrial fibrillation after successful internal cardioversion

TitleClinical predictors and time course of arrhythmia recurrence in patients with early reinitiation of atrial fibrillation after successful internal cardioversion
Authors
Issue Date2003
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2003, v. 26 n. 9, p. 1809-1814 How to Cite?
AbstractEarly reinitiation of atrial fibrillation (ERAF) was commonly observed after successful electrical cardioversion, however, the effect of ERAF on the subsequent time course of arrhythmia recurrence remains unclear. The aim of this study was to evaluate the clinical predictors and time course of AF recurrence with respect to the occurrence of ERAF after successful cardioversion. The clinical predictors and time course of AF recurrence were prospectively evaluated in 124 patients (94 men, 30 women; mean age 65 ± 9 years) with persistent AF (mean AF duration 36 ± 40 months), who underwent internal cardioversion. After cardioversion, all patients received treatment with sotalol and were monitored for AF recurrence. Successful restoration of sin us rhythm was achieved in 104 (84%) of 124 patients. ERAF was observed in 28 (27%) of 104 patients in whom 26 of them were successfully treated acutely with intravenous sotalol and repeated cardioversion. After a mean follow-up of 26 months, 29 (28%) of 104 patients remained in sinus rhythm. Kaplan-Meier analysis revealed a significantly poorer outcome with regard to the recurrence of AF in patients with ERAF (hazard ratio 1.7, P = 0.03) and in those with AF for more than 3 years (hazard ratio 1.6, P = 0.03). Despite treatment with sotalol, patients with ERAF had a significantly higher AF recurrence rate within the first day (13/26 [50%] vs 12/76 [16%], P < 0.01), but not during long-term follow-up (21/26 [81%] vs 52/76 [68%], P = 0.3). In contrast, patients with AF for more than 3 years had a similar AF recurrence rate within the first day (7/29 [24%] vs 18/73 [25%], P = 1.0), but a significantly higher recurrence rate during long-term follow-up (27/29 [93%] vs 46/73 [37%], P < 0.01). In conclusion, the occurrence of ERAF and long AF duration were independent predictors for AF recurrence after successful internal cardioversion. The difference in the time course of AF recurrence in patients with ERAF from those with long AF duration suggests distinct arrhythmogenic mechanisms.
Persistent Identifierhttp://hdl.handle.net/10722/162721
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:22:47Z-
dc.date.available2012-09-05T05:22:47Z-
dc.date.issued2003en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2003, v. 26 n. 9, p. 1809-1814en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/162721-
dc.description.abstractEarly reinitiation of atrial fibrillation (ERAF) was commonly observed after successful electrical cardioversion, however, the effect of ERAF on the subsequent time course of arrhythmia recurrence remains unclear. The aim of this study was to evaluate the clinical predictors and time course of AF recurrence with respect to the occurrence of ERAF after successful cardioversion. The clinical predictors and time course of AF recurrence were prospectively evaluated in 124 patients (94 men, 30 women; mean age 65 ± 9 years) with persistent AF (mean AF duration 36 ± 40 months), who underwent internal cardioversion. After cardioversion, all patients received treatment with sotalol and were monitored for AF recurrence. Successful restoration of sin us rhythm was achieved in 104 (84%) of 124 patients. ERAF was observed in 28 (27%) of 104 patients in whom 26 of them were successfully treated acutely with intravenous sotalol and repeated cardioversion. After a mean follow-up of 26 months, 29 (28%) of 104 patients remained in sinus rhythm. Kaplan-Meier analysis revealed a significantly poorer outcome with regard to the recurrence of AF in patients with ERAF (hazard ratio 1.7, P = 0.03) and in those with AF for more than 3 years (hazard ratio 1.6, P = 0.03). Despite treatment with sotalol, patients with ERAF had a significantly higher AF recurrence rate within the first day (13/26 [50%] vs 12/76 [16%], P < 0.01), but not during long-term follow-up (21/26 [81%] vs 52/76 [68%], P = 0.3). In contrast, patients with AF for more than 3 years had a similar AF recurrence rate within the first day (7/29 [24%] vs 18/73 [25%], P = 1.0), but a significantly higher recurrence rate during long-term follow-up (27/29 [93%] vs 46/73 [37%], P < 0.01). In conclusion, the occurrence of ERAF and long AF duration were independent predictors for AF recurrence after successful internal cardioversion. The difference in the time course of AF recurrence in patients with ERAF from those with long AF duration suggests distinct arrhythmogenic mechanisms.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Arrhythmia Agents - Therapeutic Useen_US
dc.subject.meshAtrial Fibrillation - Physiopathology - Therapyen_US
dc.subject.meshCase-Control Studiesen_US
dc.subject.meshElectric Countershock - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRegression Analysisen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSotalol - Therapeutic Useen_US
dc.subject.meshTime Factorsen_US
dc.titleClinical predictors and time course of arrhythmia recurrence in patients with early reinitiation of atrial fibrillation after successful internal cardioversionen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1460-9592.2003.t01-1-00274.xen_US
dc.identifier.pmid12930494-
dc.identifier.scopuseid_2-s2.0-0141630306en_US
dc.identifier.hkuros100809-
dc.identifier.hkuros81579-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0141630306&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume26en_US
dc.identifier.issue9en_US
dc.identifier.spage1809en_US
dc.identifier.epage1814en_US
dc.identifier.isiWOS:000185408500004-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US

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