Electrical cardioversion for persistent or chronic atrial fibrillation: outcome and clinical factors predicting short and long term success rate.
OBJECTIVE
To assess the effectiveness and to identify predictors for successful electrical cardioversion (ECV) and maintenance of sinus rhythm, in long term follow up of patients with persistent (PAF) and chronic atrial fibrillation (CAF).


RESULTS
Retrospective analysis of medical records of 68 patients with PAF or CAF, who underwent 91 cardioversions. ECV was successful in 86 attempts (94.5%). In obese (body mass index>30) and hypertensive patients (blood pressure >140/90 mm Hg), ECV was less successful in restoring sinus rhythm (p<0.05, p<0.021, respectively). Sinus rhythm was maintained more than half a year in 42 cardioversions (61%). Treatment with beta blockers prior to cardioversion and age younger than 75 were independent factors predicting long term success (p<0.013, p<0.034, respectively). Mild or moderate enlargement of left atrium (<6 cm) did not predict relapse of the arrhythmia. Second ECV was as or more effective than the first in 82.3% of patients that underwent more than one cardioversion.


CONCLUSIONS
Conversion of atrial fibrillation by DC shock was found to be safe and effective procedure. Patients should be treated with beta blockers prior to cardioversion, if possible. Mild or moderate enlargement of left atrium is not contraindication to cardioversion. Recurrent cardioversions may be recommended.
Blich
Miry
M
Rambam Medical Center, Internal Medicine C, Haifa, Israel. mblich@priza.co.il
Edoute
Yeouda
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D002908:Chronic Disease; D004554:Electric Countershock; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome