Nakazawa, H. and Lythall, D.A. and Noh, J. and Ishikawa, N. and Sugino, K. and Ito, K. and Hardman, S.M.C. (2000) Is there a place for the late cardioversion of atrial fibrillation? A long-term follow-up study of patients with post-thyrotoxic atrial fibrillation. European Heart Journal, 21 (4). pp. 327-333. ISSN 0195-668X.
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Aims As atrial fibrillation is associated with significant mortality and morbidity, restoration of sinus rhythm is desirable. However, previous data suggest that cardioversion should be restricted to patients in whom the fibrillation is of limited duration (<1-2 years) because of high relapse rates. It may be the frequent association with cardiac disease, rather than the duration of fibrillation itself, which determined the high relapse of earlier studies. The aim of this study was to investigate rates of cardioversion. maintenance of sinus rhythm and predictors of subsequent relapse in a homogeneous group of patients without evidence of any co-existent cardiac disease. Methods and Results We report on a retrospective series of 106 patients with thyrotoxicosis-induced fibrillation but no other heart disease: 87% had been in atrial fibrillation for >12 months (median duration 28.5, interquartile range 15-47 months). Cardioversion was attempted using disopyramide and then electric shock. Ninety-eight patients were successfully cardioverted: at late follow-up, 80.6 +/- 37 months (mean +/- SD), 67% were in sinus rhythm. Conclusion Although a relationship between the duration of fibrillation and maintenance of sinus rhythm was found, the high proportion remaining in sinus rhythm, compared with other series, suggests this influence may be less important than the presence or absence of structural heart disease. (C) 2000 The European Society of Cardiology.
|Uncontrolled keywords:||longstanding atrial fibrillation; cardioversion; maintenance of sinus rhythm; disopyramide|
|Divisions:||Faculties > Science Technology and Medical Studies > Kent Institute of Medicine and Health Sciences (KIMHS)|
|Depositing User:||A. Xie|
|Date Deposited:||21 Aug 2009 16:28|
|Last Modified:||21 Aug 2009 16:28|
|Resource URI:||http://kar.kent.ac.uk/id/eprint/16452 (The current URI for this page, for reference purposes)|
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