Usefulness of risk scores and predictors of atrial fibrillation recurrence after elective electrical cardioversion

Usefulness of risk scores and predictors of atrial fibrillation recurrence after elective electrical cardioversion

Introduction Electrical cardioversion (ECV) is a frequently used procedure for restoring sinus rhythm in atrial fibrillation (AF); however, the rate of recurrence is high. The identification of patients at high risk of recurrence could influence the decision‐making process. The present study evaluat...

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Published in:Annals of noninvasive electrocardiology Vol. 29; no. 1; pp. e13095 - n/a
Main Authors: Águila‐Gordo, Daniel, Jiménez‐Díaz, Javier, Negreira‐Caamaño, Martín, Martínez‐Del Rio, Jorge, Ruiz‐Pastor, Cristina, Sánchez Pérez, Ignacio, Piqueras‐Flores, Jesús
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01-01-2024
John Wiley and Sons Inc
Wiley
Subjects:
Ablation
Antiarrhythmics
atrial fibrillation recurrence
Cardiac arrhythmia
Cardiovascular disease
Cardioversion
Chronic obstructive pulmonary disease
Decision making
Ejection fraction
electrical cardioversion
Electrocardiography
Fibrillation
Hospitals
Hypertension
Mortality
Original
Patients
Rhythm
Risk analysis
Risk factors
SLAC score
Statistical analysis
Stroke
Transient ischemic attack
Ultrasonic imaging
United States > US
electrical cardioversion
SLAC score
atrial fibrillation recurrence
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Summary:Introduction Electrical cardioversion (ECV) is a frequently used procedure for restoring sinus rhythm in atrial fibrillation (AF); however, the rate of recurrence is high. The identification of patients at high risk of recurrence could influence the decision‐making process. The present study evaluates the predictive value of risk scores in atrial fibrillation recurrence after elective electrical cardioversion. Methods Unicentric, observational, and prospective study of adult patients who have undergone an elective ECV as rhythm control strategy between July 2017 and September 2022. Results From the 283 analyzed patients (mean age 63.95 ± 10.76212, 74.9% male); 99 had paroxysmal AF (35%) and 159 (59%) presented AF recurrence during a follow‐up of 6 months. In patients with post‐ECV AF recurrence, the period of time from diagnosis until the performance of the procedure was longer (393 ± 891 vs. 195 ± 527, p = .02). No paroxysmal AF (71.3% vs. 57.8%, p = .02) and LA dilatation with >40 mL/m2 (35.9% vs. 23.3%, p = .02) volumes were more frequent within these patients. AF recurrence was more frequent in patients who had previous ECV (HR = 1.32; 95% CI: 1.12–2.35; p = .01) and more than 1 shock to recover sinus rhythm (HR = 1.62; 95% CI: 1.07–1.63; p = .01). The SLAC, ALARMEc, ATLAS, and CAAP‐AF scores were statistically significant, although with a moderate predictive capacity for post‐ECV recurrence. Conclusions Risk scores analyzed showed a modest value predicting AF recurrence after ECV. Previous ECV, and greater difficulty in restoring SR were independent predictors of recurrence. The identification of patients at high risk of recurrence could influence the decision‐making process. The risk scores analyzed in the present study showed a modest predictive capacity for AF recurrence after ECV. Time in AF, previous CVE, and a greater difficulty in restoring SR were predictors of recurrence.
Bibliography:These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
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ISSN:1082-720X
1542-474X
DOI:10.1111/anec.13095