Why the study?
Do ventricular pauses during atrial fibrillation predict relapse after electrical cardioversion in patients with persistent AF?
Do ventricular pauses during atrial fibrillation predict relapse after electrical cardioversion in patients with persistent AF?
Longer ventricular pauses (RR-max) during persistent atrial fibrillation predict a higher likelihood of relapse after electrical cardioversion.
May identify higher relapse risk after ECV; hypothesis-generating and requires prospective validation before clinical use.
AIMS: To investigate the use of ambulatory electrocardiogram (ECG) monitoring in atrial fibrillation (AF) to predict recurrence after electrical cardioversion (ECV). METHODS: RR interval variables were obtained from 24 hours ECGs recorded before ECV in 119 patients (85 men, age 66 +/- 10 years) with persistent AF. Patients were followed for 1 month. RESULTS: Of the 119 patients, 16 (13%) failed ECV and 65 (55%) were in AF at 1 week and 81 (68%) at 1 month after ECV. The maximum RR interval (RR-max) and the minimum RR interval (RR-min) during AF were found to be reproducible. The RR-max was longer in those who had AF 1 week (2.55 +/- 0.49 vs 2.01 +/- 0.52 seconds, P = 0.005) and 1 month (2.56 +/- 0.50 vs 1.89 +/- 0.43 ms; P < 0.001) after ECV than in those who maintained sinus rhythm. Those in AF at 1 month included more patients with RR-max > or = 2.8 seconds (31% vs 11% P = 0.021). The average heart rate was lower in patients with RR-max > or = 2.8 seconds, but the average rate was not predictive of AF recurrence. CONCLUSION: Ventricular pauses during AF predict relapse after ECV.
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Gallagher et al. (2010) studied this question.
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