Poor maintenance of sinus rhythm after electrical cardioversion of patients with atrial fibrillation or flutter: a 5-year follow-up of 268 consecutive patients.
OBJECTIVE
To report long-term results of direct current (DC)-cardioversion in unselected patients with atrial fibrillation (AF) or flutter.


METHODS
The study was a retrospective 5-year follow-up of all patients undergoing DC-cardioversion for AF or flutter at our institution between 1993 and 1997.


RESULTS
Three hundred and eighty-five DC-cardioversions were performed in 268 patients. Two hundred and forty-nine patients underwent cardioversion for the first time. Of these, 183 (74%) were converted to sinus rhythm. During the first month of follow-up 105 (57%) relapsed into AF. Only 33 patients (13%) of the 249 patients scheduled for cardioversion remained in sinus rhythm after 1 year. In multivariate analysis arrhythmia duration was the only variable that was associated with successful cardioversion. Periprocedural complications occurred in 9.9% of the cardioversions.


CONCLUSIONS
In daily routine only a minority of patients will maintain sinus rhythm after DC-cardioversion for AF or flutter. Also, DC-cardioversion is not without risk. These observational data suggest a conservative approach to re-establishment of sinus rhythm in patients with AF.
Dahlin
Jan
J
Department of Cardiovascular Medicine Y, Bispebjerg Hospital, University of Copenhagen, Denmark. J.Dahlin@post.tele.dk
Svendsen
Pia
P
Gadsbøll
Niels
N
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004554:Electric Countershock / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D019233:Retreatment / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents