Cardiovascular Events of Electrical Cardioversion Under Optimal Anticoagulation in Atrial Fibrillation: The Multicenter Analysis

Title
Cardiovascular Events of Electrical Cardioversion Under Optimal Anticoagulation in Atrial Fibrillation: The Multicenter Analysis
Authors
박진규
Keywords
Atrial fibrillation; cardioversion; cardiovascular events; safety
Issue Date
2015-11
Publisher
YONSEI UNIV COLL MEDICINE
Citation
YONSEI MEDICAL JOURNAL, v. 56, NO 6, Page. 1552-1558
Abstract
Purpose: Electric cardioversion has been successfully used in terminating symptomatic atrial fibrillation (AF). Nevertheless, large-scale study about the acute cardiovascular events following electrical cardioversion of AF is lacking. This study was performed to evaluate the incidence, risk factors, and clinical consequences of acute cardiovascular events following electrical cardioversion of AF. Materials and Methods: The study enrolled 1100 AF patients (mean age 60 11 years) who received cardioversion at four tertiary hospitals. Hospitalizations for stroke/transient ischemic attack, major bleedings, and arrhythmic events during 30 days post electric cardioversion were assessed. Results: The mean duration of anticoagulation before cardioversion was 95.8 +/- 51.6 days. The mean International Normalized Ratio at the time of cardioversion was 2.4 +/- 0.9. The antiarrhythmic drugs at the time of cardioversion were class I(45%), amiodarone (40%), beta-blocker (53%), calcium-channel blocker (21%), and other medication (11%). The success rate of terminating AF via cardioversion was 87% (n=947). Following cardioversion, 5 strokes and 5 major bleedings occurred. The history of stroke/transient ischemic attack (OR 6.23, 95% CI 1.69-22.90) and heart failure (OR 6.40, 95% CI 1.77-23.14) were among predictors of thromboembolic or bleeding events. Eight patients were hospitalized for bradyarrhythmia. These patients were more likely to have had a lower heart rate prior to the procedure (p=0.045). Consequently, 3 of these patients were implanted with a permanent pacemaker. Conclusion: Cardioversion appears as a safe procedure with a reasonably acceptable cardiovascular event rate. However, to prevent the cardiovascular events, several risk factors should be considered before cardioversion.
URI
https://synapse.koreamed.org/DOIx.php?id=10.3349/ymj.2015.56.6.1552http://hdl.handle.net/20.500.11754/29163
ISSN
0513-5796; 1976-2437
DOI
http://dx.doi.org/10.3349/ymj.2015.56.6.1552
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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