Yu.I. Zalizna, K.O. Mikhaliev, O.J. Zharinov Predictors of arrhythmia recurrence after the first episode of atrial fibrillation during 6-months follow-up

The aim – to determine the clinical, anamnestic characteristics and indicators of the structural and functional state of the myocardium, which may predict arrhythmia recurrence in patients with reverse episode of the first-diagnosed atrial fibrillation (AF) during 6-months follow-up.

Material and methods. Among 124 patients with first diagnosed AF in 88 patients AF episode terminated with sinus rhythm restoration. In order to compare the baseline clinical, anamnestic and instrumental characteristics, groups of patients with (n=44) and without (n=44) documented recurrence of AF were formed retrospectively. In these groups, the frequency of detection of risk factors, concomitant diseases, laboratory parameters, the course of the first episode of AF, data on echocardiography, and daily ECG monitoring after recovery of sinus rhythm were compared. Multifactor analysis was performed to determine the independent predictors of AF relapse.

Results.The relapsing course of AF is associated with older age, higher incidence of certain concomitant diseases, in particular, heart failure, hypertension and diabetes, and more severe left ventricular hypertrophy. The most significant predictors of the occurrence of arrhythmia recurrence after the first episode of AF after the restoration of sinus rhythm were CHA2DS2-VASc score (≥ 2 versus 0: odds ratio (OR) 3.135 (95 % confidence intervals (CI) 1.341–7.333); Р=0.008) and C-reactive protein level (≥ 6 mg/L versus < 6 mg/L: OR 3.041 (95 % CI 1.656–5.584) P<0.001). Conclusions. During 6-months follow-up arrhythmia recurrence was registered in 50 % patients with first episode of AF. Independent predictors of the AF recurrence were CHA2DS2-VASc score two or more, as well as the CRP ≥ 6 mg/L. These aspects should be taken into account at individualized assessment of the need for antiarrhythmic and antithrombotic therapy in patients with first detected AF after restoration of sinus rhythm.

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