CLINICAL AND ELECTRO CARDIOGRAPHICALPREDICTORS OF IMMEDIATE RECURRENCE OF ATRIALFIBRILLATION AFTER EXTERNAL CARDIOVERSION

摘要

Background and Aim: Recurrence of atrial fibrillation (AF) is a major problem after external cardioversion (EC). However, information about predictors of immediate recurrence of AF (IRAF) are limited. We aimed to investigate the predictors of IRAF after EC. Methods: The ninety-two patients (42 male, mean age 59 +/- 10 years) undergoing EC for chronic AF (mean 27 +/- 18 months) were evaluated. Surface ECGs were recorded before and after EC continuously. Results: Eighty patients had successful EC. Twenty patients (25%) experienced IRAF in first minute of sinus rhythm (SR) restoration. In 15 of 20 patients (75%) IRAF was initiated by short-long-short sequence (SLS) due to atrial ectopic beats (AEBs). Left atrial dimension (LAD) greater then 60 mm was a strong predictor of IRAF (p<0.001), with a 4.7-fold greater likelihood of recurrence compared to left atrial dimension up to 60 mm. Age greater than 65 years was the other strong predictor of IRAF (p<0.01). The P wave dispersion was significantly higher in patients with recurrence of AF after EC than without recurrence (48+A7 vs. 26+/-14 mm, p<0.01). Conclusion: Presence of SLS due to AEBs, significantly enlarged LAD, older age, P wave dispersion are independent predictors of AF recurrence after EC.