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- Title
Can We Predict the Failure of Electrical Cardioversion of Acute Atrial Fibrillation? The FinCV Study.
- Authors
GRÖNBERG, TONI; HARTIKAINEN, JUHA E. K.; NUOTIO, ILPO; BIANCARI, FAUSTO; VASANKARI, TUIJA; NIKKINEN, MARKO; YLITALO, ANTTI; AIRAKSINEN, K. E. JUHANI
- Abstract
Background Data on predictors of failure of electrical cardioversion of acute atrial fibrillation are scarce. Methods We explored 6,906 electrical cardioversions of acute (<48 hours) atrial fibrillation in 2,868 patients in a retrospective multicenter study. Results The success rate of electrical cardioversion was 94.2%. In 26% of unsuccessful cardioversions, the cardioversion was performed successfully later. Antiarrhythmic drug therapy, short (<12 hours) duration of atrial fibrillation episode, advanced age, permanent pacemaker, history of atrial fibrillation episodes within 30 days before cardioversion, and β-blockers were independent predictors of unsuccessful electrical cardioversion. In the subgroup of patients with cardioversion of the first atrial fibrillation episode (N = 1,411), the short duration of episode (odds ratio [OR] = 2.28; 95% confidence interval [CI] 1.34-3.90, P = 0.003) and advanced age (OR = 1.03; 95% CI 1.02-1.05, P < 0.001) were the only independent predictors of unsuccessful cardioversion. After successful cardioversion, the rate of early (<30 days) clinical recurrence of atrial fibrillation was 17.3%. The index cardioversion being performed due to the first atrial fibrillation episode was the only predictor of remaining in the sinus rhythm. Conclusion A short (<12 hours) duration of acute atrial fibrillation is a significant predictor of unsuccessful cardioversion, especially during the first attack. First atrial fibrillation episode was the only predictor of remaining in the sinus rhythm.
- Subjects
ELECTRIC countershock; MYOCARDIAL depressants; ATRIAL fibrillation; CHI-squared test; CLINICAL trials; CONFIDENCE intervals; MEDICAL cooperation; RESEARCH; RESEARCH funding; RISK assessment; DISEASE relapse; LOGISTIC regression analysis; TREATMENT effectiveness; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test; THERAPEUTICS
- Publication
Pacing & Clinical Electrophysiology, 2015, Vol 38, Issue 3, p368
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.12561