Burden and Timing of Premature Atrial Contractions After Electrical Cardioversion of Persistent Atrial Fibrillation Do Not Predict Its Recurrence

• Published in: Clinical cardiology (Mahwah, N.J.) N.J.), 2008-10, Vol.31 (10), p.492-497
• Main Authors: Poçi, Dritan, Abrahamsson, Britt‐Marie, Bergfeldt, Lennart, Edvardsson, Nils
• Format: Article
• Language: English
• Subjects: Aged; atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Atrial Premature Complexes - epidemiology; Atrial Premature Complexes - etiology; Atrial Premature Complexes - physiopathology; Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Clinical Investigation; Clinical Investigations; Diseases of mother, fetus and pregnancy; early reinitiations of atrial fibrillation; elective direct current; Electric Countershock - adverse effects; Electric Countershock - methods; Electrocardiography; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Heart; Heart Rate - physiology; Humans; immediate reinitiations of atrial fibrillation; Incidence; Male; Medical sciences; Pregnancy. Fetus. Placenta; premature atrial contraction; Prognosis; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Time Factors
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.20285

Background The heart is susceptible to recurrence of atrial fibrillation (AF) during the period immediately following conversion to sinus rhythm (SR). It is less clear whether various onset or trigger mechanisms can predict AF recurrence after direct current (DC) cardioversion of persistent AF. Methods In this study, 172 patients (117 men), mean age 69 ± 11 y, and with persistent AF underwent elective electrical cardioversion. A detailed analysis was made of the heart rhythm and potential AF trigger mechanisms based on 5 min electrocardiogram (ECG) recordings after conversion. Results Of 151 patients discharged in SR, 45 (30%) had a recurrence of AF within 1 wk. Premature atrial contractions (PACs) were the most common potential trigger, occurring on an average of 3/min. They were equally frequent in patients with and without immediate and early reinitiation of AF, and in patients with and without AF recurrence at the 1‐wk follow‐up visit. Other trigger mechanisms were too infrequent to allow conclusions. Conclusion Premature atrial contractions were the most common potential trigger mechanism occurring immediately after cardioversion in patients with persistent AF. However, they neither predicted immediate and/or early reinitiations, nor recurrences during the first wk after cardioversion. Copyright © 2008 Wiley Periodicals, Inc.