Self- limited episodes of atrial fibrillation after direct current cardioversion predict recurrence of persistent atrial fibrillation

Abstract

Objective To evaluate if self-limited episodes of atrial fibrillation after direct current(DC) cardioversion predict re- currence of persistent atrial fibrillation. Methods Consecutive patients with persistent atrial fibrillation, scheduled for DC cardiover- sion were prospectively included in the study. Ambulatory ECG Hoher monitoring (24 h) was performed one, three and 6 weeks after successful cardioversion. Results A total of 80 patients were prospectively included in the study. Sinus rhythm was restored in 73 pa- tients (88%). At 6 weeks of follow -up 40 patients out of 73 (54%) had sinus thythm, and 33 patients (46%) had relapsed into per- sistent atrial frbrillation. Eight out of these 34 patients (24%) had bursts of atrial fibrillation at their first Holter recording, compared to 12 patients out of 40 (30%) in sinus rhythm at 6 weeks (P > 0.05). On the first, second and third Holter recording 21 patients out of 51 (41%), 22 patients out of 43 (51%) and 15 out of 40 patients (38%) had self - limited bursts of atrial fibrillation,respeetively. Condusion In patients successfully converted to sinus rhythm self- limited bursts of atrial fibrillation do not predict recurrence of persistent atrial fibrillation during 6 weeks of follow up. Brief self- limited episodes of atrial fibrillation are common, and the incidence and duration of such episodes are constant during a 6 weeks period after DC cardioversion. Key words: Arrhythmia; Atrial fibrillation; Cardioversion