CLINICAL CHARACTERISTICS AND OUTCOMES OF PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION WHO UNDERGO MULTIPLE DIRECT-CURRENT CARDIOVERSION PROCEDURES
A. García-Fernández, F. Marín-Ortuño, J.G. Martínez-Martínez, A, Ibáñez-Criado, J.L. Ibáñez-Criado, V. Roldán-Schilling, M. Valdés,, F. Sogorb-Garri
Arrhtyhmia Unit, Cardiology Department, general Hospital of Alicante, Spain. Cardiology Department, Hospital Virgen de la Arrixaca, Murcia, Spain. Haematology Department, Hospital Morales Meseguer, Murcia, Spain
Introduction: Although immediate success rates of DC cardioversion (CV) in NVAF patients are known to be very high, recurrence is the usual pattern, being many patients submitted to multiple procedures. We aimed to determine if clinical profile and long-term outcome are different in these patients.
Methods: We studied 326 patients who underwent 456 DC CV (form January 2008 to August 2011). We compared clinical characteristics, thromboembolic risk (CHA2DS2-VASc score), long-term maintenance of sinus rhythm and event rates (embolism, major bleeding and death) in both two groups of patients: Group 1 (?2 CV) and Group 2 (?3 CV).
Results: Patients in Group 2 (N=21) were younger (61.1?12.0 vs 66.9?10.9 years, p=0.02) and had less thromboembolic risk (CHA2DS2-VASc: 2.14?1.52 vs 2.86?1.59, p=0.04) than patients in Group 1 (N=305). During a median follow up of 740 [327-1224] days, the proportion of patients in sinus rhythm and the event rates were similar in both groups (23.4% vs 35.0%, p:0.57).
Conclusions: AF patients who undergo multiple CV procedures tend to be younger and have less thromboembolic risk. The proportion of maintenance of sinus rhythm and the rate of events are similar in both groups.
Baseline characteristics of patients in Group 1 (?2 CV) and in Group 2 (?3 CV).
| Patient
|
Group 1 (N=305)
|
Group 2 (N=21)
| p
|
| Male (%) |
210 (68.9) |
18 (87.5) |
0.1 |
| Age (years) |
66.9±10.9 |
61.1±12.0 |
0.01 |
| Idiopathic AF(%) |
27 (9) |
3 (14.3) |
0.41 |
| Hypertension (%) |
246 (80.9) |
15 (71.4) |
0.53 |
| Diabetes (%) |
83 (27.4) |
5(23.8) |
0.72 |
| Heart failure (%) |
78 (25.7) |
63% |
0.72 |
| Previous embolism (%) |
19 (6.3) |
1 (4.8) |
0.78 |
| Heart disease (%) |
121 (40.2) |
7 (33) |
0.53 |
| CHA2DS2-VASc score |
2.86±1.59 |
2.14±1.52 |
0.04 |
Proportion of patients in sinus rhythm at end of follow-up and event rate.
| Patient
|
Group 1 (N=305)
|
Group 2 (N=21)
|
p
|
| Sinus rhythm (%) |
71 (23.4) |
7 (35.0) |
0.57 |
| Embolic events (%) |
18(6) |
3 (15) |
0.11 |
| Major bleeding (%) |
9 (3) |
0 (0) |
0.43 |
| Death (%) |
19 (6.3) |
0 (0) |
0.24 |
