The prognostic impact of successful cardioversion of atrial fibrillation in patients with organic heart disease

• Published in: Clinical research in cardiology Vol. 96; no. 2; pp. 103 - 108
• Main Authors: Kleemann, T, Becker, T, Dönges, K, Vater, M, Gut, B, Schneider, S, Senges, J, Seidl, K
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.02.2007
• Subjects: Aged; Atrial Fibrillation - etiology; Atrial Fibrillation - mortality; Atrial Fibrillation - therapy; Atrial Flutter - etiology; Atrial Flutter - mortality; Atrial Flutter - therapy; Cardiac arrhythmia; Cardiology; Cardiovascular disease; Electric Countershock; Female; Follow-Up Studies; Heart Diseases - complications; Humans; Male; Middle Aged; Mortality; Multivariate analysis; Prognosis; Prospective Studies; Survival Analysis; Treatment Outcome
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-006-0466-8

The aim of the study was to evaluate the prognostic impact of successful cardioversion (CV) compared to failed CV in patients with atrial fibrillation (AF) and organic heart disease. A total of 471 consecutive patients with organic heart disease from the prospective single center anticoagulation registry ANTIK who underwent CV of AF or atrial flutter were analyzed. 417 patients (89%) could be successfully cardioverted. In 54 patients (11%) CV failed, these patients remained in AF. After 5 years there were 92 (24%) deaths among patients with restored sinus rhythm at index admission and 20 (38%) deaths among those who remained in AF after CV (unadjusted OR 1.9, 95% CI 1.1-3.6). After adjustment for age, gender and ejection fraction, successful CV was not associated with a beneficial effect on mortality (OR 0.72, 95% CI 0.43-1.21). Thus, successful CV is not an independent predictor of mortality on multivariate analysis. However, it remains a marker for a better prognosis in patients with organic heart disease as these patients have a lower unadjusted longterm mortality.