title: [Predictors of reversion to sinus rhythm previous to electrical cardioversion in patients with persistent atrial fibrillation treated with anti-arrhythmic drugs].
abstract: BACKGROUND
  Some patients with persistent atrial fibrillation treated pharmacologically revert to sinus rhythm prior to electrical cardioversion. Knowledge of factors predicting this effect may be clinically useful.
  
  
  METHODS
  Data were obtained from patients enrolled in the study REgistro sobre la cardioVERSión en España (REVERSE) and treated with antiarrhythmic drugs that potentially may cause pharmacological reversal. We analized by means of logistic regression predictive factors related to reversion to sinus rhythm precardioversion.
  
  
  RESULTS
  Of the 752 patients treated with antiarrhythmic drugs, 160 (21%) reverted to sinus rhythm without electrical cardioversion. Amiodarone was the most widely used active compound (82%) and apparently the most effective. However, differences with other antiarrhythmic drugs were not significant (amiodarone 22% versus other antiarrhythmic drugs 17%, P = .22). Lack of obesity (body mass index < 30 kg/m(2)) (odds ratio [OR] = 1.9; P = .006), duration of atrial fibrillation < 1 year (OR 3.4; P=.02) and the absence of structural heart disease (OR 1,59; P = .01) were identified as independent variables with predictive value of pharmacological reversal to sinus rhythm. Among patients treated with amiodarone who met these criteria, the frequency of successful treatment increased up to 31%.
  
  
  CONCLUSIONS
  In patients with persistent atrial fibrillation treated with anti-arrhythmic drugs, lack of obesity, duration of atrial fibrillation < 1 year and the absence of structural heart disease are predictors of reversion to sinus rhythm before electrical cardioversion.
authors.affiliation: Servicio de Cardiologia, Hospital de Sta, Creu i Sant Pau, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Viñolas
authors.forename: Fernando
authors.initials: F
authors.lastname: Freire
authors.forename: César
authors.initials: C
authors.lastname: Romero-Menor
authors.forename: Josep M
authors.initials: JM
authors.lastname: Alegret
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005424:Flecainide / Q000627:therapeutic use; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011405:Propafenone / Q000627:therapeutic use; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D020127:Recovery of Function; D012074:Remission Induction; D013015:Sotalol / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D013015:Sotalol; D005424:Flecainide; D000638:Amiodarone