Key result
The presence of fragmented QRS independently predicted atrial fibrillation recurrence after successful electrical cardioversion (76.4% vs 23.5%; HR 9.670, 95% CI 4.714-19.837, p<0.001).
Why the study?
Many patients develop recurrent AF after restoring normal sinus rhythm despite optimal medical therapy, and the relationship between fragmented QRS (fQRS) and AF recurrence following successful electrical cardioversion remained to be assessed.
Does the presence of fragmented QRS predict the recurrence of atrial fibrillation after successful electrical cardioversion in patients with nonvalvular persistent AF?
Cohort (n=306)
Does the presence of fragmented QRS predict the recurrence of atrial fibrillation after successful electrical cardioversion in patients with nonvalvular persistent AF?
The presence of fragmented QRS on ECG is a strong independent predictor of atrial fibrillation recurrence following successful electrical cardioversion.
Answers are grounded in this paper and cite their sources.
Supports fQRS for post-cardioversion AF recurrence risk stratification; hypothesis-generating and should not yet change practice.
OBJECTIVE: Atrial fibrillation (AF), the most common cardiac rhythm disorder, affects approximately 2% of the general population and is associated with increased risk of stroke and mortality as well as reduced exercise capacity and quality of life. After restoring normal sinus rhythm, a portion of these patients develops recurrent AF despite optimal medical treatment. In this study, we aimed to assess the relationship between the presence of fragmented QRS (fQRS) and AF recurrence following successful electrical cardioversion (ECV). MATERIAL AND METHODS: A total of 306 patients with nonvalvular persistent AF achieving restoration of the sinus rhythm after successful ECV were included in this study. After ECV, patients were monitored at least 6 months for recurrence. The patients were divided into two groups according to the presence of fQRS and compared for AF recurrence during follow-up. RESULTS: Patients were followed up for a mean time of 220 ± 113 days. AF recurred in 119 patients, corresponding to a recurrence rate of 38.8%. AF recurrence was found to be significantly increased in patients with fQRS as compared to those without fQRS (76.4% vs. 23.5%, p < .001). Furthermore, the presence of fQRS was higher in patients with recurrent AF as compared to others (57.1% vs. 11.2%, p < .001). In multiple regression analyses, the presence of fQRS was one of the independent predictors of AF recurrence (hazard ratio: 9.670, 95% CI: 4.714-19.837, p < .001). CONCLUSION: The presence of fQRS may be associated with the recurrence of AF after successful ECV in persistent nonvalvular AF patients.
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Eren et al. (2019) conducted a cohort in Nonvalvular persistent atrial fibrillation (n=306). Presence of fragmented QRS (fQRS) vs. Absence of fragmented QRS was evaluated on Atrial fibrillation recurrence (HR 9.670, 95% CI 4.714-19.837, p=<0.001). The presence of fragmented QRS independently predicted atrial fibrillation recurrence after successful electrical cardioversion (76.4% vs 23.5%; HR 9.670, 95% CI 4.714-19.837, p<0.001).
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