Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricular function

https://doi.org/10.1016/0002-9149(93)91015-AGet rights and content

Abstract

One hundred twenty-four consecutive patients (85%) with paroxysmal atrial fibrillation (AF) and 21 (15%) with atrial flutter (API) were studied immediately after pharmacologic br electrical cardioversion to sinus rhythm. Mean age was 59 ± 13 years (range 23 to 79). Patients with reduced left ventricular function were excluded from the study. After restoration to sinus rhythm, the clinical course of all patients was followed for the first recurrence of paroxysmal AF or AFI irrespective of the therapeutic approach. Mean follow-up was 23 ± 16 months. After 12 months of followup, 50% of all patients remained in sinus rhythm. Univariate analysis indicated that coronary artery disease (relative risk 1.9; 95% confidence interval 0.9–3.9), history of paroxysmal AF or AFI (2.3; 1.1–5.0), female sex (2.3; 1.1–4.6), pulmonary disease (3.9; 1.9–7.6) and valvular heart disease (4.4; 2.2–8.8) were associated with an increased risk for recurrent or frequent episodes of paroxysmal AF or AFI. No predictors were found to be associated with a decrease in length of the recurrence-free period after successful conversion to sinus rhythm. Multivariate analysis identified history of AF or AH (odds ratio 2.5; 95% confidence interval 0.9–6.4), coronary artery disease (3.1; 1.1–8.2) and female sex (3.4; 1.3–8.9) as independent predictors for recurrent or frequent episodes of paroxysmal AF or AH. The presence of these risk factors should be taken into account when prophylactic therapy with antiarrhythmic drugs is being considered in the treatment of paroxysmal AF or AH.

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This study was presented in part at the 41st Annual Scientific Session of the American College of Cardiology, April 12–16, 1992, Dallas, Texas.

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