Burden and timing of premature atrial contractions after electrical cardioversion of persistent atrial fibrillation do not predict its recurrence.
BACKGROUND
The heart is susceptible to recurrence of atrial fibrillation (AF) during the period immediately following conversion to sinus rhythm (SR). It is less clear whether various onset or trigger mechanisms can predict AF recurrence after direct current (DC) cardioversion of persistent AF.


METHODS
In this study, 172 patients (117 men), mean age 69 +/- 11 y, and with persistent AF underwent elective electrical cardioversion. A detailed analysis was made of the heart rhythm and potential AF trigger mechanisms based on 5 min electrocardiogram (ECG) recordings after conversion.


RESULTS
Of 151 patients discharged in SR, 45 (30%) had a recurrence of AF within 1 wk. Premature atrial contractions (PACs) were the most common potential trigger, occurring on an average of 3/min. They were equally frequent in patients with and without immediate and early reinitiation of AF, and in patients with and without AF recurrence at the 1-wk follow-up visit. Other trigger mechanisms were too infrequent to allow conclusions.


CONCLUSIONS
Premature atrial contractions were the most common potential trigger mechanism occurring immediately after cardioversion in patients with persistent AF. However, they neither predicted immediate and/or early reinitiations, nor recurrences during the first wk after cardioversion.
Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. dritan_poci@yahoo.com
Dritan
D
Poçi
Britt-Marie
BM
Abrahamsson
Lennart
L
Bergfeldt
Nils
N
Edvardsson
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D018880:Atrial Premature Complexes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004554:Electric Countershock / Q000009:adverse effects* / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors