DC cardioversion for AF frequently fails to achieve sinus rhythm; temporary amiodarone therapy before first DC cardioversion may reduce the failure rate and the requirement for repeat cardioversion in selected patient populations

Background: DC cardioversion (DCCV) is commonly used to assess the symptomatic benefit of sinus rhythm (SR) when deciding whether to offer further rhythm control therapies such as AF ablation. However, acute failure of DCCV to achieve SR and early reversion to AF are common. This makes assessment of...

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Bibliographic Details
Published in:European journal of arrhythmia & electrophysiology 2020-01, Vol.6, p.71
Main Authors: Williams, HJ, Gough, J, Kitchin, A, Vaidya, N, Bond, R
Format: Article
Language:English
Subjects:
Ablation
Cardioversion
Patients
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Summary:Background: DC cardioversion (DCCV) is commonly used to assess the symptomatic benefit of sinus rhythm (SR) when deciding whether to offer further rhythm control therapies such as AF ablation. However, acute failure of DCCV to achieve SR and early reversion to AF are common. This makes assessment of the symptomatic benefit of SR very difficult and many patients undergo repeat DCCV, often while taking amiodarone. We sought to identify factors associated with acute DCCV failure and early reversion to AF, and whether amiodarone therapy before first DCCV could reduce the failure rate in high risk populations Methods: Retrospective analysis of electronic medical records of patients undergoing DCCV during a 12-month period from Jan-Dec 2017 Results: 239 patients underwent DCCV. Mean age 68 (range 31-89), 68% male. 68% underwent first DCCV, 23% DCCV 2, 7% DCCV 3, and 2% DCCV 4. Follow-up and echocardiographic data was available for 229/239 (96%) patients. 42/229 (18%) achieved SR for
ISSN:2058-3869
2058-3877