cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2023.1.n2145cardio-2145Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESПоздние рецидивы мерцательной аритмии и трепетания предсердий у пациентов, направленных на плановую электрическую кардиоверсиюLate recurrence of atrial fibrillation and flutter in patients referred for elective electrical cardioversionhttps://orcid.org/0000-0002-7288-3362ТонерЛиамTonerLiam

MD

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MD

Department of Cardiology, Heidelberg, Victoria, Australia 

 

liam.toner@yahoo.comПроймосХеленаProimosHelena

MBBS

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MBBS

Department of Cardiology, Heidelberg, Victoria, Australia

liam.toner@yahoo.comСкаллиТимотиScullyTimothy

MBBS

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MBBS

Department of Cardiology, Heidelberg, Victoria, Australia

liam.toner@yahoo.comКоДжефферсонKoJefferson

MBBS 

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MBBS

Department of Cardiology, Heidelberg, Victoria, Australia

liam.toner@yahoo.comКошиАнупKoshyAnoop

MBBS FRACP

Отделение кардиологии, Гейдельберг, Виктория, Австралия

Медицинский факультет, Мельбурн, Виктория, Австралия

MBBS FRACP

Department of Cardiology, Heidelberg, Victoria, Australia 

Department of Medicine, Melbourne, Victoria, Australia

 

liam.toner@yahoo.comХорриганМаркHorriganMark

MBBS FRACP

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MBBS FRACP

Department of Cardiology, Heidelberg, Victoria, Australia

liam.toner@yahoo.comЛимХан С.LimHan S.

MBBS FRACP PhD

Отделение кардиологии, Гейдельберг, Виктория, Австралия

Медицинский факультет, Мельбурн, Виктория, Австралия

MBBS FRACP PhD

Department of Cardiology, Heidelberg, Victoria, Australia 

Department of Medicine, Melbourne, Victoria, Australia

liam.toner@yahoo.comЛинТинаLinTina

MBBS FRACP

Отделение кардиологии, Гейдельберг, Виктория, Австралия

MBBS FRACP

Department of Cardiology, Heidelberg, Victoria, Australia

liam.toner@yahoo.comФарукОмарFarouqueOmar

MBBS FRACP PhD

Отделение кардиологии, Гейдельберг, Виктория, Австралия

Медицинский факультет, Мельбурн, Виктория, Австралия

MBBS FRACP PhD

Department of Cardiology, Heidelberg, Victoria, Australia 

Department of Medicine, Melbourne, Victoria, Australia

liam.toner@yahoo.comБольница ОстинаАвстралияAustin HospitalAustraliaБольница Остина; Мельбурнский университетАвстралияAustin Hospital; University of MelbourneAustralia2023310120236315459Copyright © Kardiomag, 20232023KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/2145

Цель    Основная цель исследования состояла в том, чтобы установить частоту отдаленных рецидивов фибрилляции предсердий (ФП) в популяции пациентов, перенесших плановую электрическую кардиоверсию. Вторичные цели включали оценку успешности процедуры электрической кардиоверсии, клинические предикторы долгосрочного сохранения синусового ритма (СР) и госпитализаций, связанных с ФП.Материал и методы    Проведено ретроспективное когортное исследование. Последовательно были включены пациенты (n = 316), перенесшие плановую электрическую кардиоверсию.Результаты    Успешное восстановление СР достигнуто у 266 (84%) пациентов. 224 (84%) пациента наблюдались в последующем в течение среднего периода 3,5 года (межквартильный интервал 2,7–4,3). У большинства пациентов (150 (67%)) рецидивы ФП/трепетания регистрировались в среднем через 240 дней. Клинические предикторы рецидива ФП включали наличие ФП в анамнезе (ОР 0,63, p=0,038) и дилатацию левого предсердия (ОР 4,13, p=0,048). Поддержание СР было связано с меньшим количеством незапланированных госпитализаций по поводу ФП (ОР 3,25, p<0,01).Заключение    Электрическая кардиоверсия характеризовалась высокой эффективностью в восстановлении синусового ритма во время процедуры. Однако долгосрочная частота рецидивов ФП была высокой, а рецидивы ФП были связаны с увеличением числа госпитализаций. Эти результаты подчеркивают важность клинической бдительности и мультимодального лечения как части комплексной и эффективной стратегии контроля ритма.

Aim    The primary aim was to ascertain long-term rates of atrial fibrillation (AF) recurrence in this all-comer patient population undergoing elective electrical cardioversion (DCR). Secondary aims included procedural DCR success, clinical predictors of long-term maintenance of sinus rhythm (SR) and AF related hospitalizations.Material and Methods    A retrospective cohort study was conducted. Consecutive patients (n=316) undergoing elective DCR were included.Results    Successful immediate reversion to SR was attained in 266 (84 %) of patients. 224 (84 %) patients were followed up for a median period of 3.5 years (IQR 2.7–4.3). Most patients (150 [67 %]) had recurrence of AF / flutter at a median time of 240 days. Clinical predictors of AF recurrence included a history of AF (HR 0.63, p=0.038) and a dilated left atrium (HR 4.13, p=0.048). Maintenance of SR was associated with fewer unplanned hospitalizations for AF (HR 3.25, p<0.01).Conclusion    There was high procedural success post DCR. However, long-term rates of AF recurrence were high, and AF recurrences were associated with increased hospitalizations. These findings underscore the importance of clinical vigilance and multi-modal management as part of a comprehensive and effective rhythm control strategy.

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The authors declare that there are no conflicts of interest present.