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Ventricular Pauses during Atrial Fibrillation Predict Relapse after Electrical Cardioversion: A Prospective Study
Author(s) -
GALLAGHER MARK MICHAEL,
GUO XIAO HUA,
POLONIECKI JAN,
CAMM A. JOHN
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02755.x
Subject(s) - medicine , atrial fibrillation , cardiology , electrical cardioversion , sinus rhythm , ambulatory , cardioversion , confidence interval , prospective cohort study , rr interval , ambulatory ecg , heart rate , anesthesia , heart rate variability , blood pressure
Aims: To investigate the use of ambulatory electrocardiogram (ECG) monitoring in atrial fibrillation (AF) to predict recurrence after electrical cardioversion (ECV).Methods: RR interval variables were obtained from 24 hours ECGs recorded before ECV in 119 patients (85 men, age 66 ± 10 years) with persistent AF. Patients were followed for 1 month.Results: Of the 119 patients, 16 (13%) failed ECV and 65 (55%) were in AF at 1 week and 81 (68%) at 1 month after ECV. The maximum RR interval (RR‐max) and the minimum RR interval (RR‐min) during AF were found to be reproducible. The RR‐max was longer in those who had AF 1 week (2.55 ± 0.49 vs 2.01 ± 0.52 seconds, P = 0.005) and 1 month (2.56 ± 0.50 vs 1.89 ± 0.43 ms; P < 0.001) after ECV than in those who maintained sinus rhythm. Those in AF at 1 month included more patients with RR‐max ≥ 2.8 seconds (31% vs 11% P = 0.021). The average heart rate was lower in patients with RR‐max ≥ 2.8 seconds, but the average rate was not predictive of AF recurrence.Conclusion: Ventricular pauses during AF predict relapse after ECV. (PACE 2010; 934–938)