Role of smoking in the recurrence of atrial arrhythmias after cardioversion.
We aimed to determine whether smoking status affects the recurrence of atrial fibrillation or atrial flutter in patients after cardioversion. The clinical data of patients undergoing cardioversion for atrial flutter from January 1, 2000 to December 31, 2005 were prospectively collected. Arrhythmia recurrences were detected by retrospective review of comprehensive medical records and were determined using electrocardiography. The smoking history was prospectively collected through a standardized clinical form and subsequently categorized as lifetime nonsmoker, exsmoker, or current smoker. Univariate and multivariate associations with end points for clinical and lifestyle variables were assessed with Cox proportional hazards models. Women who were current smokers at cardioversion had a greater risk of atrial arrhythmia recurrence than did nonsmokers (hazard ratio 1.71, 95% confidence interval 1.10 to 2.67, p = 0.02). The increased risk of arrhythmia recurrence in female smokers was not seen in male smokers. Compared to lifetime nonsmokers, the mortality hazard ratio among men was 1.18 (95% confidence interval 0.88 to 1.58; p = 0.28) in exsmokers and 1.93 (95% confidence interval 1.20 to 3.11; p = 0.007) in current smokers. The risk of death after cardioversion was not increased in women. In conclusion, smoking is an independent predictor of atrial arrhythmia recurrence after cardioversion in women; however, an increased mortality risk, but not arrhythmia recurrence risk, was seen in men.
Kinoshita
Masayoshi
M
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Herges
Regina M
RM
Hodge
David O
DO
Friedman
Lindsay
L
Ammash
Naser M
NM
Bruce
Charles J
CJ
Somers
Virend
V
Malouf
Joseph F
JF
Askelin
Jason
J
Gilles
James A
JA
Gersh
Bernard J
BJ
Friedman
Paul A
PA
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D001282:Atrial Flutter / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D015897:Comorbidity; D004554:Electric Countershock; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*