[Independent predictive factors of acute and first year success after electrical cardioversion in patients with chronic atrial fibrillation].
OBJECTIVE
We retrospectively analyzed the predictive factors of successfully electrical cardioversion in patients with chronic atrial fibrillation.


METHODS
We included 118 patients, 68 men and 50 women, with a mean age of 65.1 years and a length of arrhythmia evolution of 83.3 days. These patients consecutively underwent electrical cardioversion in our Cardiology Department with a follow-up of one year to determine relapses. Structural cardiopathy was observed in 63.6% of the patients and 43.7% presented a left atrium between 4 and 5 cms. We analyzed the clinical and echocardiographic factors which predict the acute and first year success of electrical cardioversion.


RESULTS
The cardioversion was effective in 73.7% (CI 95%, 64.6%-81.1%) of the patients and 35.6% (CI 95%, 25.8%-46.6%) had a relapse within the first year. The inexistence of cardiomyopathy and therapy with amiodarone were predictive of acute success (p < 0.04 and p < 0.03, respectively). The length of arrhythmia evolution did not predict acute success but did so when relapses were analyzed. The size of the left atrium is predictive of both acute and long term success (p < 0.02 and p < 0.001, respectively). Logistic regression showed that the size of the left atrium and the patient's age were the only predictive factors of acute and first year success.


CONCLUSIONS
Electrical cardioversion is very efficient in the short-term, despite numerous relapses. Patient age and the size of left atrium are associated with acute and long-term success of cardioversion.
Ortiz De Murúa
J A
JA
Sección de Cardiología, Servicio de Medicina Interna, Zamora.
del Carmen Avila
M
M
Ochoa
C
C
de La Fuente
L
L
Moreno De Vega
J C
JC
del Campo
F
F
Villafranca
J L
JL
D000368:Aged; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D002908:Chronic Disease; D004452:Echocardiography; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies
D000889:Anti-Arrhythmia Agents