Abstract:
Atrial Fibrillation (AF) is a common arrhythmia associated with decreased quality of life and increased mortality. Treatment options include electrical cardioversion (ECV) to restore sinus rhythm. However, success rates at one year have been reported to be low and influenced by a range of factors. The aim of this study was to determine which factors influence patients’ chance of being AF-free for one year post-ECV in a real-world cohort. Consecutive patients were retrospectively identified from a database of patients undergoing ECV. Demographic data, clinical factors reported to influence AF-free following ECV (identified from an initial literature review) along with cardiac-rhythm at one year were recorded. From this data, univariate and multivariate logistical regression analysis were performed. A total of 195 patients met the inclusion and exclusion criteria. At one year 68 (34.4%) patients were AF-free. In univariate analysis, the absence of left atrial (LA) enlargement was the only significant factor (p = 0.012) reduced likelihood of being AF-free. However, in multivariate analysis, 3 factors where associated with improved outcomes, the presence of hypertension (p = 0.038), lack of LA enlargement (p = 0.027), and the use of rate-control medication prior to ECV (p = 0.025). Despite the world literature describing multiple factors influencing long-term maintenance of sinus rhythm following ECV, this study only identified 3 factors; hypertension, prior-medication with rate-control medications and lack of LA enlargement significantly increased being AF-free one year.
Keywords:
DC cardioversion; Atrial fibrillation; Sinus rhythm; Outcomes