[Increased incidence of spontaneous conversion to sinus rhythm in patients with paroxysmal atrial fibrillation].
BACKGROUND
The aim of our study was to evaluate spontaneous conversion rate to sinus rhythm in patients with paroxysmal atrial fibrillation (AF) not submitted to any treatment (pharmacological and/or electrical).


METHODS
From January 1985 to September 1990, 123 consecutive patients with paroxysmal AF were hospitalized in our department. In 11 patients arrhythmia was due to arrhythmogenic conditions; 34 patients were submitted to emergency treatment with drugs (23 cases) or electrical cardioversion (11 cases); 78 patients (41 males; mean age 65.1 years; 37 females: mean age 68.6 years), without emergency problems were enrolled in our study and were submitted to a four-day observation period without any therapy, except in case of worsening. 35 patients were free from heart disease; in the other 43, 28 had chronic coronary disease, 11 hypertensive cardiovascular disease, 2 rheumatic valvular disease, 1 hypertrophic cardiomyopathy and 1 chronic cor pulmonale.


RESULTS
In all 78 patients sinus rhythm was restored spontaneously - in about 90% of them within 24 hours. Mean time to conversion was 21 hours (range 1-96 hours). Cardioversion occurred in similar percentage and at the same time in both subgroups of patients (with and without heart disease).


CONCLUSIONS
Therefore, given the risks and cost of every treatment, a 24-hour observation period without therapy could be useful in those patients presenting with paroxysmal atrial fibrillation without emergency problems.
Buscarini
L
L
I Divisione di Medicina Generale, Ospedale di Piacenza.
Imberti
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
Elevata incidenza di ripristino spontaneo del ritmo sinusale in pazienti con fibrillazione atriale parossistica.