title: The prognostic impact of successful cardioversion of atrial fibrillation in patients with organic heart disease.
abstract: The aim of the study was to evaluate the prognostic impact of successful cardioversion (CV) compared to failed CV in patients with atrial fibrillation (AF) and organic heart disease. A total of 471 consecutive patients with organic heart disease from the prospective single center anticoagulation registry ANTIK who underwent CV of AF or atrial flutter were analyzed. 417 patients (89%) could be successfully cardioverted. In 54 patients (11%) CV failed, these patients remained in AF. After 5 years there were 92 (24%) deaths among patients with restored sinus rhythm at index admission and 20 (38%) deaths among those who remained in AF after CV (unadjusted OR 1.9, 95% CI 1.1-3.6). After adjustment for age, gender and ejection fraction, successful CV was not associated with a beneficial effect on mortality (OR 0.72, 95% CI 0.43-1.21). Thus, successful CV is not an independent predictor of mortality on multivariate analysis. However, it remains a marker for a better prognosis in patients with organic heart disease as these patients have a lower unadjusted longterm mortality.
authors.affiliation: Herzzentrum Ludwigshafen, Klinikum Ludwigshafen, Medizinische Klinik B, Germany. Thomas.Kleemann.Lu@t-online.de
authors.forename: T
authors.initials: T
authors.lastname: Kleemann
authors.forename: T
authors.initials: T
authors.lastname: Becker
authors.forename: K
authors.initials: K
authors.lastname: Dönges
authors.forename: M
authors.initials: M
authors.lastname: Vater
authors.forename: B
authors.initials: B
authors.lastname: Gut
authors.forename: S
authors.initials: S
authors.lastname: Schneider
authors.forename: J
authors.initials: J
authors.lastname: Senges
authors.forename: K
authors.initials: K
authors.lastname: Seidl
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D001282:Atrial Flutter / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome