Electrical cardioversion of atrial fibrillation and the risk of brady-arrhythmic events
| Autor: | Frederik Dalgaard, Christian Torp-Pedersen, Jannik Langtved Pallisgaard, M. H. Ruwald, Jacob Tønnesen, Peter Vestergaard Rasmussen, Morten Lock Hansen, Paul Blanche, Gunnar Gislason |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Electric Countershock Disease Logistic regression Older patients Recurrence Internal medicine Atrial Fibrillation Medicine Humans In patient Aged Heart Failure business.industry Absolute risk reduction Atrial fibrillation Middle Aged medicine.disease Electrical cardioversion Logistic Models Treatment Outcome Heart failure Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Rasmussen, P V, Blanche, P, Dalgaard, F, Gislason, G H, Torp-Pedersen, C, Tønnesen, J, Ruwald, M H, Pallisgaard, J L & Hansen, M L 2022, ' Electrical cardioversion of atrial fibrillation and the risk of brady-arrhythmic events ', American Heart Journal, vol. 244, pp. 42-49 . https://doi.org/10.1016/j.ahj.2021.10.182 |
| ISSN: | 1097-6744 |
| Popis: | Background Electrical cardioversion (ECV) is a common procedure for terminating atrial fibrillation (AF). ECV is associated with brady-arrhythmic events, however, the age-specific risks of clinically significant brady-arrhythmic events are unknown. Methods Using Danish nationwide registers, we identified patients with AF at their first non-emergent ECV between 2005 and 2018 and estimated their 30-day risk of brady-arrhythmic events. Moreover, factors associated with increased risks of brady-arrhythmias were identified. Absolute risks were estimated using logistic regression models fitted with natural splines as well as standardization (G-formula). Results We identified 20,725 eligible patients with a median age of 66 years (IQR 60-72) and most males (73%). The 30-day risks of brady-arrhythmic events after ECV were highly dependent on age with estimated risks ranging from 0.5% (95% CI 0.2-1.7) and 1.2% (95% CI 0.99-1.5) to 2.7% (95% CI 2.1-3.3) and 5.1% (95% CI 2.6-9.7) in patients aged 40, 65, 80, and 90 years, respectively. Factors associated with brady-arrhythmias were generally related to cardiovascular disease (eg, ischemic heart disease, heart failure, valvular AF) or a history of syncope. We found no indications that pre-treatment with anti-arrhythmic drugs conferred increased risks of brady-arrhythmic events (standardized absolute risk difference -0.25% [95% CI -0.67 to 0.17]). Conclusions ECV conferred clinically relevant 30-day risks of brady-arrhythmic events, especially in older patients. Anti-arrhythmic drug treatment was not found to increase the risk of brady-arrhythmias. Given the widespread use of ECV, these data should provide insights regarding the potential risks of brady-arrhythmic events. |
| Databáze: | OpenAIRE |
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