Abstract

Introduction. The existing guidelines do not contain a clear algorithm for predicting the late recurrences of atrial fibrillation (AFib). Objectives. We have studied the predictors of late recurrence of arrhythmia in patients with persistent AFib after the restoration of sinus rhythm (SR). Research methods. A prospective single-center study included 120 hospitalized patients with persistent AFib who underwent successful cardioversion. The recurrence of AFib was assessed in the early period after cardioversion by recording 12-channel ECG, Holter ECG monitoring and event ECG monitoring. After a nine-month period follow-up visit was performed. Baseline demographic, clinical-functional features and comorbidities were compared in group with (n = 87) and without (n = 33) late recurrences of Afib. Results. There were no differences in demographic, anthropometric data and comorbidities. Patients with late recurrence of AFib had a lower heart rate (HR) after SR recovery (p <0.001). Early recurrences of AFib were found in 43 (49.4%) patients with late recurrences of arrhythmia and only in two (6.0%) without late recurrences (p <0.001). Patients with late recurrences of arrhythmia had a lower average daily HR (p <0.001), a higher number of single atrial extrasystoles (p = 0.001), atrial pairs and runs (p = 0.01) recorded by Holter ECG monitoring. Conclusions. Late recurrences of arrhythmia during the nine-month follow-up period were reported in 72.5% of patients. Groups of patients with and without late recurrence of arrhythmia had significant differences in the incidence of early recurrences, mean HR on SR, and the presence of atrial extrasystoles after rhythm recovery.

Highlights

  • The existing guidelines do not contain a clear algorithm for predicting the late recurrences of atrial fibrillation (AFib)

  • We have studied the predictors of late recurrence of arrhythmia in patients with persistent AFib after the restoration of sinus rhythm (SR)

  • Late recurrences of arrhythmia during the nine-month follow-up period were reported in 72.5% of patients

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Summary

Introduction

The existing guidelines do not contain a clear algorithm for predicting the late recurrences of atrial fibrillation (AFib). Recent studies show high prevalence of arrhythmia early recurrences after pharmacological or electrical cardioversion of persistent atrial fibrillation and flutter (AFib/AFl) [1]. Evaluation of its necessity and optimal duration depends on probability of late recurrences of arrhythmia after restoration of sinus rhythm [2]. Attention to the predictors of Afib/AFl recurrences is mostly related to the issue of asymptomatic arrhythmias, taking into account the diagnostic value of long-term ECG monitoring [5]. The aim of the research was to study the possible predictors of arrhythmia late recurrences in patients with persistent AFib/AFl after restoration of sinus rhythm

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