[The prediction of atrial fibrillation recurrence after electrical cardioversion with the chemoreflex sensitivity].
Patients with paroxysmal atrial fibrillation have a lower chemoreflex sensitivity (CHRS) which is characterized as an autonomic dysfunction. Because of this observation we examined the theory of an autonomic dysfunction as the reason for the reccurrence of atrial fibrilation after electrical cardioversion.


METHODS
We measured the CHRS among 43 patients 24 h after successful electrical cardioversion and the patients were controlled for at least 6 months.


RESULTS
During the six months of follow-up a recurrence was observed in 18 patients with a mean of 8.3 days. There was no difference in organic heart disease or in the use of drugs. Left atrial diameter was not significantly larger in patients with a recurrence. Patients with a recurrence have a significantly lower CHRS than patients with sinus rhythm (2.41 +/- 1.82 vs 5.62 +/- 3.02 ms/mmHg, p < 0.04). The diagnostic value of a CHRS below 3.0 ms/mmHg achieved a specificity of 68%, a sensitivity of 67%, a positive and negative predictive value of 60% and 74%.


CONCLUSIONS
An analysis of CHRS seems to be an appropriate method to predict a recurrence of atrial fibrillation. The predictive power of the method has to be examined by prospective investigations of a larger patient population and a longer follow-up. Patients with paroxysmal atrial fibrillation have a lower chemoreflex sensitivity (CHRS) which is characterized as an autonomic dysfunction. Because of this observation we examined the theory of an autonomic dysfunction as the reason for the recurrence of atrial fibrillation after electrical cardioversion.
Budeus
M
M
Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Klinik und Poliklinik B der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany. budeus@med.uni-duesseldorf.de
Hennersdorf
M
M
Perings
C
C
Strauer
B E
BE
D000319:Adrenergic beta-Antagonists; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology; D017704:Baroreflex; D001794:Blood Pressure; D002628:Chemoreceptor Cells / Q000187:drug effects / Q000503:physiopathology*; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000319:Adrenergic beta-Antagonists