OBJECTIVES: We sought to gain insights into the early recurrence of atrial fibrillation (ERAF) after cardioversion shocks delivered by permanently implanted rhythm management systems. BACKGROUND: Several reports have characterized ERAF, but these reports used a limited definition and did not evaluate an association between clinical or device variables and ERAF. METHODS: A total of 144 patients with recurrent, drug-resistant, symptomatic atrial fibrillation (AF) underwent implantation of an atrial rhythm management system (Medtronic Jewel AF, Model 7250, Minneapolis, Minnesota). The device was programmed to deliver cardioversion shocks automatically and/or on patient command. The incidence of ERAF was evaluated after 1,092 successful shocks among 97 patients. Three different ERAF definitions were used: recurrence within 1 min, 1 h or 1 day. Multiple clinical and device variables were assessed for their relationship with ERAF. RESULTS: The per-patient incidences of ERAF were 44%, 61% and 70% for ERAF within 1 min, 1 h and 1 day, respectively. The per-episode incidences of ERAF were 17%, 30% and 43% for ERAF within 1 min, 1 h and 1 day, respectively. Variables that were independently associated with ERAF included AF duration <3 h before termination, more than one shock required to cardiovert and the absence of a previous myocardial infarction. The most potent variable was AF duration <3 h, associated with a threefold increase in the incidence of ERAF. CONCLUSIONS: Recurrence of AF early after ambulatory shock cardioversion is common. In this retrospective study, both clinical and device variables were predictive.
OBJECTIVES: We sought to gain insights into the early recurrence of atrial fibrillation (ERAF) after cardioversion shocks delivered by permanently implanted rhythm management systems. BACKGROUND: Several reports have characterized ERAF, but these reports used a limited definition and did not evaluate an association between clinical or device variables and ERAF. METHODS: A total of 144 patients with recurrent, drug-resistant, symptomatic atrial fibrillation (AF) underwent implantation of an atrial rhythm management system (Medtronic Jewel AF, Model 7250, Minneapolis, Minnesota). The device was programmed to deliver cardioversion shocks automatically and/or on patient command. The incidence of ERAF was evaluated after 1,092 successful shocks among 97 patients. Three different ERAF definitions were used: recurrence within 1 min, 1 h or 1 day. Multiple clinical and device variables were assessed for their relationship with ERAF. RESULTS: The per-patient incidences of ERAF were 44%, 61% and 70% for ERAF within 1 min, 1 h and 1 day, respectively. The per-episode incidences of ERAF were 17%, 30% and 43% for ERAF within 1 min, 1 h and 1 day, respectively. Variables that were independently associated with ERAF included AF duration <3 h before termination, more than one shock required to cardiovert and the absence of a previous myocardial infarction. The most potent variable was AF duration <3 h, associated with a threefold increase in the incidence of ERAF. CONCLUSIONS: Recurrence of AF early after ambulatory shock cardioversion is common. In this retrospective study, both clinical and device variables were predictive.
Authors: Marco Budeus; Marcus Hennersdorf; Christian Perings; Heinrich Wieneke; Raimund Erbel; Stefan Sack Journal: Ann Noninvasive Electrocardiol Date: 2005-10 Impact factor: 1.468
Authors: Bob Weijs; Ione Limantoro; Tammo Delhaas; Cees B de Vos; Yuri Blaauw; Richard P M Houben; Sander Verheule; Ronny Pisters; Harry J G M Crijns Journal: Clin Cardiol Date: 2018-03-22 Impact factor: 2.882