May 20, 2026Journal of the American College of Cardiology
Early Recurrences of Atrial Fibrillation After Electrical Cardioversion: A Result of Fibrillation-Induced Electrical Remodeling of the Atria?
Key result
Intracellular calcium-lowering drugs during AF linked to maintained sinus rhythm after cardioversion.
- P=0.03
- n=61
Why the study?
To investigate whether the timing and incidence of AF relapse within 1 month after cardioversion reflects electrical remodeling and whether prevention of intracellular calcium overload influences it.
Does the use of intracellular calcium-lowering drugs during atrial fibrillation reduce the recurrence of AF after electrical cardioversion?
Population
61 patients cardioverted for chronic AF
Comparison
Influence of patient characteristics and medication on AF relapse
Design
Prospective observational cohort study with transtelephonic monitoring
Follow-up
1 month
Authors
Discussion
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Implication
Early calcium-lowering drugs may aid sinus rhythm maintenance post-cardioversion; leaves open confirmation in contemporary trials.
Key Points
- The aim was to evaluate if early AF recurrences indicate electrical remodeling influenced by calcium overload treatment.
- Transtelephonic monitoring of 61 patients who underwent cardioversion for chronic AF.
- Evaluated the daily incidence of AF recurrence and performed Cox regression analysis to assess influencing factors.
- Monitored patient characteristics and the use of intracellular calcium-lowering medications.
- 57% of patients experienced a relapse of AF within one month, peaking in the first 5 days.
- There was a significant positive correlation (p = 0.0013) between shortest coupling interval duration post-cardioversion and AF recurrence timing.
- Use of calcium-lowering drugs was significantly associated with maintaining sinus rhythm (p = 0.03).
Study Design
Type
Cohort (n=61)
Structured PICO
Does the use of intracellular calcium-lowering drugs during atrial fibrillation reduce the recurrence of AF after electrical cardioversion?
P
Population
61 patients cardioverted for chronic atrial fibrillation, followed for 1 month using transtelephonic monitoring.
E
Exposure
Use of intracellular calcium-lowering drugs during atrial fibrillation
C
Comparator
Non-use of intracellular calcium-lowering drugs (implied by multivariate analysis)
O
Outcome
Daily incidence of recurrence of atrial fibrillation during the first month after cardioversionhard clinical
Main Result
p-value: p=0.03
The use of intracellular calcium-lowering medications during atrial fibrillation may reduce early recurrences after electrical cardioversion, possibly by attenuating electrical remodeling.
Cite This Study
Tieleman et al. (1998) conducted a cohort in Chronic atrial fibrillation (n=61). Intracellular calcium-lowering drugs vs. No intracellular calcium-lowering drugs was evaluated on Maintenance of sinus rhythm after cardioversion (p=0.03). Use of intracellular calcium-lowering drugs during atrial fibrillation was significantly associated with maintenance of sinus rhythm after cardioversion (p=0.03).