title: [Late recurrences of atrial fibrillation in patients after direct-current cardioversion].
abstract: OBJECTIVE
  To analyze factors after successful direct-current cardioversion in patients with atrial fibrillation and to explore late recurrences of the arrhythmia.
  
  
  METHODS
  Forty-three patients with atrial fibrillation without associated valvular heart disease, who underwent non-emergent cardioversion within the years 2002-2006, were included. We retrospectively analyzed clinical data from the medical records. Late reccurence of the arrhythmia was defined as arrhythmia in patients discharged with sinus rhythm.
  
  
  RESULTS
  Median follow-up of the patients was 33 (17, 48) months. We found 20 late recurrences of atrial fibrillation in the total group of 43 patients after successful direct-current cardioversion (46.5%). In a 6-month period after direct-current cardioversion the recurrence of arrhythmia was found in two patients, in a one-year period in 6 patients and in a period longer than one year in 12 patients. Median time to recurrence was 15 (6, 33) months. Females relapsed more frequently than males (p < 0.02), what could be explained by higher age, incidence of hypertension and thyreopathy in females. Patients with a history of thyropathy had more frequent occurrence of arrhythmia, despite normal values of TSH, as compared to patients without a history of thyropathy (p < 0.04). Patients with recurrence of the atrial fibrillation had higher systolic pressure (130 vs 120 mm Hg, p < 0.05) and pulse arterial pressure (50 vs 40 mm Hg, p < 0.01) after cardioversion. No significant difference between the two groups in age, left atrium diameter, left ventricle ejection fraction and cardiovascular, or non-cardiovascular risk factors was found.
  
  
  CONCLUSIONS
  Despite successful direct-current cardioversion, the risk of late recurrence of the atrial fibrillation in a following period is at least 46.5%. Females, patients with a history of thyropathy and those with higher systolic and pulse arterial pressures are at higher risk of late recurrences.
authors.affiliation: IV. Interná klinika Lekárskej fakulty UK a FNsP Bratislava, Slovenská republika. marcela.gurcikova@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Gurciková
authors.forename: J
authors.initials: J
authors.lastname: Kaluzay
authors.forename: S
authors.initials: S
authors.lastname: Remisová
authors.forename: O
authors.initials: O
authors.lastname: Jurkovicová
authors.forename: P
authors.initials: P
authors.lastname: Pontuch
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence