THE PREDICTION OF ATRIAL FIBRILLATION RECURRENCE AT VARIOUS METHODS OF SINUS RHYTHM RECOVERY

Abstract

Aim. To estimate probability of atrial fibrillation (AF) recurrence at various methods of sinus rhythm recovery. Material and methods. Patients (n=153) with nonvalvular AF lasting from 24 hours to 6 months were examined. All patients were divided into 3 groups. In group 1 (n=49) sinus rhythm was restored by the drug therapy, in the group 2 (n=57) – by the electrical cardioversion, and in the group 3 (n=47) patients underwent radio-frequency isolation of pulmonary veins. Echocardiography was performed in all patients during AF, and also on the 1, 3, 5, 15 days and in 6 months after sinus rhythm recovery. Results. The absence of AF paroxysms within first 2 weeks after sinus rhythm recovery was a significant predictor of sinus rhythm preservation (р<0.001) and reduction in a number of AF paroxysms р<0.001 during 6 months of follow-up. Emergence of AF paroxysms during the first 2 weeks predicted an increase of their probability within next 6 months (odds ratio=15.37). Significant interrelation between the time of left atrium function restoration (peak A<0.5m/s) and probability of AF paroxysms emergence in early (up to 2 weeks) and late (till 6 months) follow-up periods was also observed (р<0.05). Conclusions. Peak A>0.5 m/s measured by transmitral flow in the first 24 hours after sinus rhythm recovery as well as absence of AF paroxysms within 2 first weeks after sinus rhythm recovery were significant predictors of the sinus rhythm preservation up to 6 months at any type of cardioversion.

Keywords

• atrial fibrillation
• thromboembolic disorders
• cardioversion
• sinus rhythm recovery