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Article: Incidence and modes of onset of early reinitiation of atrial fibrillation after successful internal cardioversion, and its prevention by intravenous sotalol

TitleIncidence and modes of onset of early reinitiation of atrial fibrillation after successful internal cardioversion, and its prevention by intravenous sotalol
Authors
KeywordsAtrial fibrillation
Low energy cardioversion
Sotalol
Issue Date1999
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 1999, v. 82 n. 3, p. 319-324 How to Cite?
AbstractObjectives - To study the incidence and mode of onset of early reinitiation of atrial fibrillation (ERAF) following successful internal cardioversion of chronic atrial fibrillation, and to determine the effects of sotalol in the prevention of ERAF. Design - The incidence and modes of onset of ERAF and the acute effects of intravenous sotalol in the prevention of ERAF were studied retrospectively. Setting - Electrophysiology laboratory at a university teaching hospital. Patients - 64 patients, mean (SD) age 62 (10) years, who underwent internal cardioversion of chronic atrial fibrillation (mean duration of atrial fibrillation 31 (39) months). Main outcome measures - ECGs and intracardiac electrograms recorded during the internal cardioversion of atrial fibrillation using 3/3 ms biphasic, R wave synchronised shocks. Results - 52 patients (81%) had successful electrical cardioversion, and 20 (31%) of these had ERAF during the procedure. There was no clinical predictor for the occurrence of ERAF. Fifty eight episodes of ERAF were observed. Five ERAF episodes (9%) had preceding bradycardia and 53 (91%) of these were triggered by atrial premature beats with normal preceding heart rate. Atrial premature beats that reinitiated atrial fibrillation had a shorter coupling interval (333 (43) ms υ 396 (100), p < 0.001) and a lower prematurity index (0.44 (0.11) υ 0.55 (0.14), p < 0.001) than those that did not reinitiate atrial fibrillation. Repeated shock delivery and increasing the defibrillation energy did not prevent ERAF. Intravenous sotalol infusion decreased the numbers of atrial premature beats and prolonged their coupling interval, and prevented ERAF after repeated defibrillation in 83% of patients with ERAF. Conclusions - ERAF is a significant clinical problem after successful internal cardioversion of chronic atrial fibrillation, and was observed in up to 31% of patients. In most episodes, ERAF was triggered by short coupling atrial premature beats with preceding normal heart rate. Intravenous sotalol was effective in preventing ERAF in most cases.
Persistent Identifierhttp://hdl.handle.net/10722/42415
ISSN
2015 Impact Factor: 5.693
2015 SCImago Journal Rankings: 2.647
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorAyers, GMen_HK
dc.date.accessioned2007-01-29T08:49:26Z-
dc.date.available2007-01-29T08:49:26Z-
dc.date.issued1999en_HK
dc.identifier.citationHeart, 1999, v. 82 n. 3, p. 319-324en_HK
dc.identifier.issn1355-6037en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42415-
dc.description.abstractObjectives - To study the incidence and mode of onset of early reinitiation of atrial fibrillation (ERAF) following successful internal cardioversion of chronic atrial fibrillation, and to determine the effects of sotalol in the prevention of ERAF. Design - The incidence and modes of onset of ERAF and the acute effects of intravenous sotalol in the prevention of ERAF were studied retrospectively. Setting - Electrophysiology laboratory at a university teaching hospital. Patients - 64 patients, mean (SD) age 62 (10) years, who underwent internal cardioversion of chronic atrial fibrillation (mean duration of atrial fibrillation 31 (39) months). Main outcome measures - ECGs and intracardiac electrograms recorded during the internal cardioversion of atrial fibrillation using 3/3 ms biphasic, R wave synchronised shocks. Results - 52 patients (81%) had successful electrical cardioversion, and 20 (31%) of these had ERAF during the procedure. There was no clinical predictor for the occurrence of ERAF. Fifty eight episodes of ERAF were observed. Five ERAF episodes (9%) had preceding bradycardia and 53 (91%) of these were triggered by atrial premature beats with normal preceding heart rate. Atrial premature beats that reinitiated atrial fibrillation had a shorter coupling interval (333 (43) ms υ 396 (100), p < 0.001) and a lower prematurity index (0.44 (0.11) υ 0.55 (0.14), p < 0.001) than those that did not reinitiate atrial fibrillation. Repeated shock delivery and increasing the defibrillation energy did not prevent ERAF. Intravenous sotalol infusion decreased the numbers of atrial premature beats and prolonged their coupling interval, and prevented ERAF after repeated defibrillation in 83% of patients with ERAF. Conclusions - ERAF is a significant clinical problem after successful internal cardioversion of chronic atrial fibrillation, and was observed in up to 31% of patients. In most episodes, ERAF was triggered by short coupling atrial premature beats with preceding normal heart rate. Intravenous sotalol was effective in preventing ERAF in most cases.en_HK
dc.format.extent132288 bytes-
dc.format.extent27136 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.languageengen_HK
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_HK
dc.relation.ispartofHearten_HK
dc.rightsHeart. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAtrial fibrillationen_HK
dc.subjectLow energy cardioversionen_HK
dc.subjectSotalolen_HK
dc.subject.meshAdrenergic beta-antagonists - therapeutic useen_HK
dc.subject.meshElectric countershocken_HK
dc.subject.meshSotalol - therapeutic useen_HK
dc.subject.meshAtrial fibrillation - etiology - prevention & control - therapyen_HK
dc.subject.meshAnti-arrhythmia agents - therapeutic useen_HK
dc.titleIncidence and modes of onset of early reinitiation of atrial fibrillation after successful internal cardioversion, and its prevention by intravenous sotalolen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1355-6037&volume=82&issue=3&spage=319&epage=324&date=1999&atitle=Incidence+and+modes+of+onset+of+early+reinitiation+of+atrial+fibrillation+after+successful+internal+cardioversion,+and+its+prevention+by+intravenous+sotalolen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid10455082-
dc.identifier.pmcidPMC1729161-
dc.identifier.scopuseid_2-s2.0-0032819840en_HK
dc.identifier.hkuros48057-
dc.identifier.hkuros49713-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032819840&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume82en_HK
dc.identifier.issue3en_HK
dc.identifier.spage319en_HK
dc.identifier.epage324en_HK
dc.identifier.isiWOS:000082357500016-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridAyers, GM=7102015157en_HK

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