Maintenance of sinus rhythm for 30 days post-cardioversion in patients with persistent atrial fibrillation significantly decreased the average QTc interval from 449 ms to 422 ms (P=0.04).
Observational (n=9)
Does successful cardioversion and maintenance of sinus rhythm improve ventricular electrophysiologic properties in patients with persistent atrial fibrillation?
Successful restoration and maintenance of sinus rhythm in persistent AF leads to reverse electrical remodeling of the ventricles within 30 days, as evidenced by improved repolarization parameters.
Absolute Event Rate: 422% vs 449%
p-value: p=0.04
BACKGROUND: Atrial fibrillation (AF) has been shown to be associated with reduced survival and increased ventricular arrhythmogenesis. The purpose of this study was to assess the effects of AF with adequate rate control on the electrophysiologic properties of the ventricles. We hypothesized that AF results in increased ventricular arrhythmogenic risk and that reverse remodeling occurs post-successful cardioversion. METHODS: In nine patients with persistent AF, we recorded 12-lead electrocardiograms (ECGs) and 1-hour high-resolution Holter ECGs (H12+, Mortara Instrument, Inc. Milwaukee, WI, USA; recorders 1000 sps immediately following cardioversion (Day 1) and after 30 days of maintaining sinus rhythm (Day 30). We measured QTc, QT dispersion, and calculated estimates of mean ventricular action potential duration (RT), diastolic interval (DI), T-wave width (TW), T-wave peak-to-end, and their respective scatter on Day 1 and Day 30. Maintenance of normal sinus rhythm was confirmed with a weekly trans-telephonic ECG transmission. RESULTS: The average QTc interval decreased from 449 ± 28 ms on Day 1 to 422 ± 36 ms on Day 30 (P = 0.04). There was no significant difference in the average QT dispersion. A significant decrease was also noted in DI and TW scatter at Day 30 when compared with Day 1 (P = 0.03 and 0.04, respectively). A decrease in RT scatter was also noted albeit not statistically significant (P = 0.07). CONCLUSION: Our results suggest a greater propensity to ventricular arrhythmogenesis in the immediate period following restoration of sinus rhythm and reverse electrical remodeling of the ventricles during the first month after successful maintenance of sinus rhythm. (PACE 2010; 33:1198-1202).
Akoum et al. (Tue,) conducted a observational in Persistent Atrial Fibrillation (n=9). Maintenance of sinus rhythm vs. Immediate post-cardioversion period (Day 1) was evaluated on Average QTc interval (p=0.04). Maintenance of sinus rhythm for 30 days post-cardioversion in patients with persistent atrial fibrillation significantly decreased the average QTc interval from 449 ms to 422 ms (P=0.04).