title: Predictors of sinus rhythm after electrical cardioversion of atrial fibrillation: results from a data mining project on the Flec-SL trial data set.
abstract: OBJECTIVE
  Data mining is the computational process to obtain information from a data set and transform it for further use. Herein, through data mining with supportive statistical analyses, we identified and consolidated variables of the Flecainide Short-Long (Flec-SL-AFNET 3) trial dataset that are associated with the primary outcome of the trial, recurrence of persistent atrial fibrillation (AF) or death.
  
  
  RESULTS
  The 'Ranking Instances by Maximizing the Area under the ROC Curve' (RIMARC) algorithm was applied to build a classifier that can predict the primary outcome by using variables in the Flec-SL dataset. The primary outcome was time to persistent AF or death. The RIMARC algorithm calculated the predictive weights of each variable in the Flec-SL dataset for the primary outcome. Among the initial 21 parameters, 6 variables were identified by the RIMARC algorithm. In univariate Cox regression analysis of these variables, increased heart rate during AF and successful pharmacological conversion (PC) to sinus rhythm (SR) were found to be significant predictors. Multivariate Cox regression analysis revealed successful PC as the single relevant predictor of SR maintenance. The primary outcome risk was 3.14 times (95% CI:1.7-5.81) lower in those who had successful PC to SR than those who needed electrical cardioversion.
  
  
  CONCLUSIONS
  Pharmacological conversion of persistent AF with flecainide without the need for electrical cardioversion is a powerful and independent predictor of maintenance of SR. A strategy of flecainide pretreatment for 48 h prior to planned electrical cardioversion may be a useful planning of a strategy of long-term rhythm control.
authors.affiliation: Medical Information Technology Solutions(MITS), Bilkent University Cyberpark, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Oto
authors.affiliation: Department of Cardiology, Memorial Ankara Hospital, Memorial Healthcare Group, Ankara, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.affiliation: Medical Information Technology Solutions(MITS), Bilkent University Cyberpark, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Katircioglu-Öztürk
authors.affiliation: Department of Computer Engineering, Faculty of Engineering, Bilkent University, Ankara, Turkey.
authors.forename: Halil Altay
authors.initials: HA
authors.lastname: Güvenir
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Karaagaoglu
authors.affiliation: Department of Cardiology, University of Mannheim, Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: Atrial Fibrillation Network Association, Münster, Germany.|Department of Cardiovascular Medicine, Division of Rhythmology, University Hospital Münster, Münster, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.affiliation: Atrial Fibrillation Network Association, Münster, Germany.|Department of Cardiology, Vincenz-Krankenhaus, Paderborn, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Goette
authors.affiliation: Department of Pharmacology, Technical University, Dresden, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Ravens
authors.affiliation: Department of Cardiology, Ludwig-Maximilians-University of Munich, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.affiliation: Department of Cardiology, Memorial Ankara Hospital, Memorial Healthcare Group, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.affiliation: Atrial Fibrillation Network Association, Münster, Germany.|Institute of Cardiovascular Sciences, University of Birmingham and SWBH and UHB NHS Trusts, Birmingham, UK.|Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
mesh_terms: D000200:Action Potentials / Q000187:drug effects*; D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D057225:Data Mining / Q000379:methods*; D016208:Databases, Factual; D066264:Datasets as Topic; D004554:Electric Countershock / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005424:Flecainide / Q000009:adverse effects / Q000627:therapeutic use*; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D000069550:Machine Learning; D008297:Male; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D016016:Proportional Hazards Models; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D005424:Flecainide
keywords: Atrial fibrillation; Cardioversion; Data mining; Flecainide; RIMARC algorithm