Relapse and mortality following cardioversion of new-onset vs. recurrent atrial fibrillation and atrial flutter in the elderly
| Autor: | Stephen C. Hammill, Win Kuang Shen, Naser M. Ammash, Paul A. Friedman, Brenda S. Moon, Ahmad A. Elesber, Bernard J. Gersh, Regina M. Herges, Virend K. Somers, Ana G Rosales, Joseph F. Malouf, David O. Hodge |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Heart disease medicine.medical_treatment Electric Countershock Cardioversion Recurrence Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm cardiovascular diseases Survival analysis Aged business.industry Hazard ratio Atrial fibrillation medicine.disease Survival Analysis Atrial Flutter Anesthesia Multivariate Analysis Cohort cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Atrial flutter Follow-Up Studies |
| Zdroj: | European Heart Journal. 27:854-860 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Aims Trials of rate control vs. rhythm control for atrial fibrillation or flutter included few patients with new-onset arrhythmia. Our objective was to assess the relapse rate and the effect of the relapse of newonset atrial arrhythmias on mortality after direct-current cardioversion (DCCV). Methods and results A cohort of 351 patients with atrial fibrillation (new onset in 179) and 126 patients with atrial flutter (new onset in 78) was followed-up after DCCV. Cox proportional hazard models were used. Median age was 74.6 years. Mean follow-up for relapse was 7.7 months; for death, 29.4 months. Patients with new-onset atrial flutter [adjusted hazard ratio (HR) ¼ 1] were more likely to maintain sinus rhythm than the patients with recurrent atrial flutter (adjusted HR ¼ 2.5, P , 0.01), new-onset atrial fibrillation (adjusted HR ¼ 2.4, P , 0.01), or recurrent atrial fibrillation (adjusted HR ¼ 2.7, P , 0.01). Patients with new-onset atrial fibrillation were as likely to have relapses as patients with recurrent atrial fibrillation or flutter. Relapse of atrial arrhythmia after DCCV was associated with increased mortality (adjusted HR ¼ 3.1, P , 0.01). Conclusion DCCV is more successful in maintaining sinus rhythm in patients with new-onset atrial flutter than in patients with new-onset atrial fibrillation. Relapse of atrial arrhythmia after cardioversion is associated with increased mortality. |
| Databáze: | OpenAIRE |
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