Electrical cardioversion for persistent atrial fibrillation or atrial flutter in clinical practice: predictors of long-term outcome
Key result
Arrhythmia duration ≥1 year (HR 2.07; 95% CI 1.29-3.33) and previous cardioversion (HR 1.67; 95% CI 1.17-2.38) predicted long-term recurrence after successful electrical cardioversion.
Population
242 patients with persistent atrial fibrillation or atrial flutter, mean age 62+/-13 years, enrolled in an…
Design
Cohort
Follow-up
930 days (median)
Authors
Discussion
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Implication
Supports identifying shorter-duration AF patients for higher cardioversion success likelihood; leaves open prospective validation of predictors.
Key Points
- The study aims to identify predictors of long-term recurrence of atrial fibrillation or flutter after successful electrical cardioversion.
- Analyzed clinical characteristics and echocardiographic parameters of 242 patients with persistent AF/AFL
- Measured acute efficacy and long-term outcomes post-electrical cardioversion
- Used multivariate Cox regression analysis to identify predictors of recurrence.
- Sinus rhythm restored in 89% of patients; maintained in 34% at 930-day follow-up
- Duration of arrhythmia >1 year associated with increased risk of recurrence (HR 2.07, 95% CI 1.29-3.33)
- Previous cardioversion linked to higher recurrence risk (HR 1.67, 95% CI 1.17-2.38).
Study Design
Type
Cohort (n=242)
Structured PICO
P
Population
242 patients with persistent atrial fibrillation or atrial flutter undergoing electrical cardioversion, followed for a median of 930 days.
E
Exposure
External electrical cardioversion
O
Outcome
Long-term AF/AFL recurrence
Main Result
Hazard Ratio: 2.07 (95% CI 1.29–3.33)
Patients with persistent AF/AFL for less than 1 year and no prior cardioversion have a higher chance of long-term success after external electrical cardioversion.
Cite This Study
Boriani et al. (2007) conducted a cohort in persistent atrial fibrillation or atrial flutter (n=242). Duration of arrhythmia ≥1 year vs. Duration of arrhythmia <1 year was evaluated on long-term AF/AFL recurrence (HR 2.07, 95% CI 1.29-3.33). Arrhythmia duration ≥1 year (HR 2.07; 95% CI 1.29-3.33) and previous cardioversion (HR 1.67; 95% CI 1.17-2.38) predicted long-term recurrence after successful electrical cardioversion.