Blood pressure prior to cardioversion predicts a conversion to sinus rhythm in patients with atrial fibrillation

Background: The effect of BP measured prior to the cardioversion has not been studied. Methods: Eighty patients (mean age 62±11 yrs, 44 men) with atrial fibrillation (AF), who underwent 92 cardioversions, were included. Non-invasive BP was measured. We performed a retrospective review of clinical data. The variables included into logistic regression analysis were: BP, age, gender, arterial hypertension, coronary artery disease, heart failure, obesity, left atrial diameter, duration of AF, antiarrhythmic and antihypertensive therapy. Results: A success rate of cardioversion was 60.9%. BP was lower in the group of patients with a successful cardioversion (mean BP 97±15 vs 104±10 mmHg, p=0.02; systolic BP 130±21 vs 140±18 mmHg, p=0.02; diastolic BP 81±14 vs 86±8 mmHg, p=0.07). Mean, systolic and diastolic BP cut-off levels with the highest sum of sensitivity and specificity were 103, 138 and 75 mmHg, respectively. Conclusions: Subjects with a successful cardioversion had lower BP measured immediately prior to the procedure. BP and concurrent antiarrhythmic treatment were the only predictors of a successful cardioversion (Tab. 1, Ref. 29).