Aims: To explore the effect of different factors on direct-current cardioversion success in patients with atrial fibrillation and atrial flutter and to explore late recurrences of the arrhythmia. Methods: One hundred eight patients with atrial fibrillation or atrial flutter without associated valvular heart disease, who underwent 128 non-emergent cardioversions within the years 2002-2006, were included. Retrospective review of clinical data from the medical records was performed. Data on late recurrence of arrhythmia were extracted till the beginning of 2007 from hospital information system. Standard statistical methods were used. Results: Direct-current cardioversion success rate was 69.9% in patients with atrial fibrillation and 94.4% in patients with atrial flutter. No significant complication of the procedure was noticed. Cardioversion success rate was higher, if the patients were pretreated with propafenone, amiodarone or sotalol. Mean blood pressure was lower in a subgroup of patients with successful cardioversion (97 ± 15 vs. 104 ± 10 mmHg, p = 0.02): also duration of the arrhythmia was shorter (median 6 days vs. median 52.5 days, p < 0.005). No correlation between cardioversion success and age, sex, obesity, left atrial diameter or a history of arterial hypertension was observed. In-hospital relapse of arrhythmia was documented in 21.9% of patients with atrial fibrillation and 17.6% of patients with atrial flutter. Late relapses were recognized in 46.5% of patients with atrial fibrillation and 39.3% patients with atrial flutter. Patients with late relapse had higher pulse blood pressure (51 ± 11 vs. 42 ± 12 mmHg, p = 0.03). Conclusions: Direct-current cardioversion is efficient and safe procedure in patients with atrial fibrillation/atrial flutter Left atrial diameter instead of arrhythmia duration is not a reliable parameter to predict cardioversion failure. Cardioversion was more effective in patients with lower blood pressure. Higher pulse blood pressure represents a risk of later arrhythmia recurrences.
|Number of pages||7|
|State||Published - Jul 1 2007|
- Atrial fibrillation
- Atrial flutter
- Direct-current cardioversion
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine