ORIGINAL PAPER
Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy
1
Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland Head of the Institute: Beata Kręcisz MD, PhD, Prof. JKU
Submission date: 2022-06-20
Final revision date: 2022-09-15
Acceptance date: 2022-09-19
Publication date: 2022-12-16
Medical Studies 2022;38(4):273-286
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Patients with atrial fibrillation (AF) are at increased risk of cardiovascular diseases and death. Evidence on the comparable effects of rhythm and heart rate control strategies in patients with AF is ambiguous.
Aim of the research:
To assess the recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with AF receiving oral anticoagulation therapy.
Material and methods:
This was a prospective, single-centre cohort study. The participants underwent transoesophageal echocardiography before direct current cardioversion (DCC). A total of 226 patients were enrolled. The primary outcome was sinus rhythm (SR) restoration after DCC for AF. All participants were followed up for 12 months to evaluate the incidence of death, systemic thromboembolic events, stroke, acute coronary syndrome, hospitalization due to worsening heart failure (HF), and recurrence of arrhythmia after SR restoration.
Results:
SR restoration was achieved after DCC in 197 (87.2 %) patients, of whom 112 (56.9%) experienced arrhythmia relapse. Significant risk factors associated with arrhythmia recurrence were -adrenergic antagonist therapy, chronic obstructive pulmonary disease, and previous stroke/transient ischaemic attack/thromboembolic events. All enrolled patients were free of acute coronary syndrome, systemic thromboembolic events, and stroke, and none of the patients died during the 12-month follow-up period. Hospitalization with worsening HF occurred in 13 patients with SR and in 10 patients with persistent AF (p = 0.42).
Conclusions:
The arrhythmia recurrence rate was high; however, cardiovascular complications and deaths did not occur. The incidence of hospitalization for HF was comparable between the AF and SR groups.
Patients with atrial fibrillation (AF) are at increased risk of cardiovascular diseases and death. Evidence on the comparable effects of rhythm and heart rate control strategies in patients with AF is ambiguous.
Aim of the research:
To assess the recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with AF receiving oral anticoagulation therapy.
Material and methods:
This was a prospective, single-centre cohort study. The participants underwent transoesophageal echocardiography before direct current cardioversion (DCC). A total of 226 patients were enrolled. The primary outcome was sinus rhythm (SR) restoration after DCC for AF. All participants were followed up for 12 months to evaluate the incidence of death, systemic thromboembolic events, stroke, acute coronary syndrome, hospitalization due to worsening heart failure (HF), and recurrence of arrhythmia after SR restoration.
Results:
SR restoration was achieved after DCC in 197 (87.2 %) patients, of whom 112 (56.9%) experienced arrhythmia relapse. Significant risk factors associated with arrhythmia recurrence were -adrenergic antagonist therapy, chronic obstructive pulmonary disease, and previous stroke/transient ischaemic attack/thromboembolic events. All enrolled patients were free of acute coronary syndrome, systemic thromboembolic events, and stroke, and none of the patients died during the 12-month follow-up period. Hospitalization with worsening HF occurred in 13 patients with SR and in 10 patients with persistent AF (p = 0.42).
Conclusions:
The arrhythmia recurrence rate was high; however, cardiovascular complications and deaths did not occur. The incidence of hospitalization for HF was comparable between the AF and SR groups.
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| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
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