Poor maintenance of sinus rhythm after electrical cardioversion of patients with atrial fibrillation or flutter: a 5‐year follow‐up of 268 consecutive patients

Abstract

Objective—To report long‐term results of direct current (DC)‐cardioversion in unselected patients with atrial fibrillation (AF) or flutter.

Design—The study was a retrospective 5‐year follow‐up of all patients undergoing DC‐cardioversion for AF or flutter at our institution between 1993 and 1997.

Results—Three hundred and eighty‐five DC‐cardioversions were performed in 268 patients. Two hundred and forty‐nine patients underwent cardioversion for the first time. Of these, 183 (74%) were converted to sinus rhythm. During the first month of follow‐up 105 (57%) relapsed into AF. Only 33 patients (13%) of the 249 patients scheduled for cardioversion remained in sinus rhythm after 1 year. In multivariate analysis arrhythmia duration was the only variable that was associated with successful cardioversion. Periprocedural complications occurred in 9.9% of the cardioversions.

Conclusion—In daily routine only a minority of patients will maintain sinus rhythm after DC‐cardioversion for AF or flutter. Also, DC‐cardioversion is not without risk. These observational data suggest a conservative approach to re‐establishment of sinus rhythm in patients with AF.

• Atrial fibrillation
• direct current cardioversion
• maintenance sinus rhythm