U.P. Chernyaha-Royko, O.J. Zharinov, N.S. Pavlyk, S.S. Pavlyk Predictors of early recurrence of arrhythmia among patients with nonvalvular persistent atrial fibrillation and flutter after cardioversion

The aim – to compare clinical and morphofunctional characteristics of patients with nonvalvular persistent atrial fibrillation and flutter (AF and AFL) with and without early arrhythmia recurrence after cardioversion.

Material and methods. One hundred and fifty patients with documented persistent AF/AFL, who underwent successful cardioversion during hospitalization period, were involved in the prospective one-center study. Scheduled registration of ECG, continuous Holter ECG monitoring and event monitoring within 7 days were performed to identify AF/AFL recurrences. Demographic, clinical and functional characteristics, concomitant diseases, treatments were compared in groups of patients with (n=50) and without (n=100) early recurrence of atrial fibrillation after cardioversion.

Results. Isolated AF occurred more often in patients without AF/AFL recurrences (Р=0.00116); AF was more often combined with different types of AFL in patients with arrhythmia recurrent episodes (Р=0.001). Patients with AF/AFL recurrences had longer duration of arrythmia history (Р=0.00048) and also tendency towards longer duration of last AF/AFL episode (Р=0.077). Patients with AF/AFL recurrences had lower daily average and minimum heart rate, larger amount of supraventricular extrasystoles (Р=0.0001), couplets (Р=0.00002) and groups (Р=0.0001) during 24-hour Holter ECG monitoring. There were more paroxysms of atrial tachycardia (Р=0.0019) in patients with AF/AFL recurrences as well.

Conclusions. Recurrent episodes of AF/AFL during hospitalization occur in one third of the patients after successful electrical or chemical cardioversion. The 24-hour Holter monitoring of ECG and event monitoring raises possibility to detect rhythm disorder at early stages after cardioversion. Presence of AFL, detection of frequent supraventricular extrasystoles, couplets and groups and short paroxysms of atrial tachyarrhythmia could be strong predictors of AF/AFL early recurrence.

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