Electrocardiographic markers of cardioversion success in patients with atrial fibrillation

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: In patients with atrial fibrillation (AF) and atrial flutter (AFL), the value of the 12-lead surface electrocardiogram (ECG) in predicting direct current cardioversion (DCCV) outcomes has not been thoroughly investigated. We sought to determine whether the type of atrial arrhythmia (AF versus AFL) and the characteristics of the atrial fibrillatory waves (fine versus coarse) on the surface ECG would help predict post DCCV outcomes. Methods: A total of 76 consecutive patients undergoing elective DCCV for persistent AF or AFL at the Minneapolis Veterans Affairs Medical Center were included in this retrospective cohort study. All patients had ECGs immediately and one month after DCCV. Results: Mean age was 67 ± 8 years and 97% of the participants were male. DCCV was immediately successful in 64 (84%) patients. Of these, 35 (46%) remained in sinus rhythm at one month. DCCV was immediately successful in all patients (N = 13) with fine AF versus 34/45 of those with coarse AF (P = 0.05). Patients with fine AF were also more likely to remain in sinus rhythm at one-month follow up compared to those with coarse AF (8/13 versus 13/45; P = 0.03). Also, at one-month follow up, the patients with AFL were more likely to maintain sinus rhythm than those with AF (14/18 of AFL versus 21/58 of AF; P = 0.003). Conclusion: The characteristics of the fibrillatory waves on surface ECG should be utilized to determine the success after DCCV in patients with AF and AFL.

Original languageEnglish (US)
Pages (from-to)885-889
Number of pages5
JournalSouthern Medical Journal
Volume102
Issue number9
DOIs
StatePublished - Sep 1 2009

Fingerprint

Electric Countershock
Atrial Fibrillation
Atrial Flutter
Electrocardiography
Veterans
Cardiac Arrhythmias
Cohort Studies
Retrospective Studies

Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Cardioversion

Cite this

@article{63e2e390bc9c40238dd380a51106e880,
title = "Electrocardiographic markers of cardioversion success in patients with atrial fibrillation",
abstract = "Background: In patients with atrial fibrillation (AF) and atrial flutter (AFL), the value of the 12-lead surface electrocardiogram (ECG) in predicting direct current cardioversion (DCCV) outcomes has not been thoroughly investigated. We sought to determine whether the type of atrial arrhythmia (AF versus AFL) and the characteristics of the atrial fibrillatory waves (fine versus coarse) on the surface ECG would help predict post DCCV outcomes. Methods: A total of 76 consecutive patients undergoing elective DCCV for persistent AF or AFL at the Minneapolis Veterans Affairs Medical Center were included in this retrospective cohort study. All patients had ECGs immediately and one month after DCCV. Results: Mean age was 67 ± 8 years and 97{\%} of the participants were male. DCCV was immediately successful in 64 (84{\%}) patients. Of these, 35 (46{\%}) remained in sinus rhythm at one month. DCCV was immediately successful in all patients (N = 13) with fine AF versus 34/45 of those with coarse AF (P = 0.05). Patients with fine AF were also more likely to remain in sinus rhythm at one-month follow up compared to those with coarse AF (8/13 versus 13/45; P = 0.03). Also, at one-month follow up, the patients with AFL were more likely to maintain sinus rhythm than those with AF (14/18 of AFL versus 21/58 of AF; P = 0.003). Conclusion: The characteristics of the fibrillatory waves on surface ECG should be utilized to determine the success after DCCV in patients with AF and AFL.",
keywords = "Atrial fibrillation, Atrial flutter, Cardioversion",
author = "Aloul, {Basel Al} and Selcuk Adabag and Ilknur Can and Henri Roukoz and Susan McClintock and Benditt, {David G} and Tholakanahalli, {Venkatakrishna N}",
year = "2009",
month = "9",
day = "1",
doi = "10.1097/SMJ.0b013e3181afe5ef",
language = "English (US)",
volume = "102",
pages = "885--889",
journal = "Southern Medical Journal",
issn = "0038-4348",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Electrocardiographic markers of cardioversion success in patients with atrial fibrillation

AU - Aloul, Basel Al

AU - Adabag, Selcuk

AU - Can, Ilknur

AU - Roukoz, Henri

AU - McClintock, Susan

AU - Benditt, David G

AU - Tholakanahalli, Venkatakrishna N

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Background: In patients with atrial fibrillation (AF) and atrial flutter (AFL), the value of the 12-lead surface electrocardiogram (ECG) in predicting direct current cardioversion (DCCV) outcomes has not been thoroughly investigated. We sought to determine whether the type of atrial arrhythmia (AF versus AFL) and the characteristics of the atrial fibrillatory waves (fine versus coarse) on the surface ECG would help predict post DCCV outcomes. Methods: A total of 76 consecutive patients undergoing elective DCCV for persistent AF or AFL at the Minneapolis Veterans Affairs Medical Center were included in this retrospective cohort study. All patients had ECGs immediately and one month after DCCV. Results: Mean age was 67 ± 8 years and 97% of the participants were male. DCCV was immediately successful in 64 (84%) patients. Of these, 35 (46%) remained in sinus rhythm at one month. DCCV was immediately successful in all patients (N = 13) with fine AF versus 34/45 of those with coarse AF (P = 0.05). Patients with fine AF were also more likely to remain in sinus rhythm at one-month follow up compared to those with coarse AF (8/13 versus 13/45; P = 0.03). Also, at one-month follow up, the patients with AFL were more likely to maintain sinus rhythm than those with AF (14/18 of AFL versus 21/58 of AF; P = 0.003). Conclusion: The characteristics of the fibrillatory waves on surface ECG should be utilized to determine the success after DCCV in patients with AF and AFL.

AB - Background: In patients with atrial fibrillation (AF) and atrial flutter (AFL), the value of the 12-lead surface electrocardiogram (ECG) in predicting direct current cardioversion (DCCV) outcomes has not been thoroughly investigated. We sought to determine whether the type of atrial arrhythmia (AF versus AFL) and the characteristics of the atrial fibrillatory waves (fine versus coarse) on the surface ECG would help predict post DCCV outcomes. Methods: A total of 76 consecutive patients undergoing elective DCCV for persistent AF or AFL at the Minneapolis Veterans Affairs Medical Center were included in this retrospective cohort study. All patients had ECGs immediately and one month after DCCV. Results: Mean age was 67 ± 8 years and 97% of the participants were male. DCCV was immediately successful in 64 (84%) patients. Of these, 35 (46%) remained in sinus rhythm at one month. DCCV was immediately successful in all patients (N = 13) with fine AF versus 34/45 of those with coarse AF (P = 0.05). Patients with fine AF were also more likely to remain in sinus rhythm at one-month follow up compared to those with coarse AF (8/13 versus 13/45; P = 0.03). Also, at one-month follow up, the patients with AFL were more likely to maintain sinus rhythm than those with AF (14/18 of AFL versus 21/58 of AF; P = 0.003). Conclusion: The characteristics of the fibrillatory waves on surface ECG should be utilized to determine the success after DCCV in patients with AF and AFL.

KW - Atrial fibrillation

KW - Atrial flutter

KW - Cardioversion

UR - http://www.scopus.com/inward/record.url?scp=70349128899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349128899&partnerID=8YFLogxK

U2 - 10.1097/SMJ.0b013e3181afe5ef

DO - 10.1097/SMJ.0b013e3181afe5ef

M3 - Article

C2 - 19668022

AN - SCOPUS:70349128899

VL - 102

SP - 885

EP - 889

JO - Southern Medical Journal

JF - Southern Medical Journal

SN - 0038-4348

IS - 9

ER -