Predictors for recurrence of atrial fibrillation after electrical cardioversion
Elizabeth Lyster Andersen, Bærum Hospital, Vestre Viken hospital trust
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia affecting more than 3% of the adult population. AF may have different time patterns, as some patients have intermittent, self-terminating episodes of AF (paroxysmal AF), whereas others have persistent AF which necessitates cardioversion to be terminated. Although the immediate success in restoring sinus rhythm is more than 90 %, approximately 50 % of the successfully cardioverted patients experience a recurrence of AF within few weeks. It is difficult to predict which patients will recur by today’s methods, and identification of better predictors may help us avoid unnecessary cardioversions.
PRE-ELECTRIC is a prospective, observational cohort study, and a minimum of 200 patients with persistent AF will be included. The study will investigate new potential predictors for AF recurrence and the feasibility of patient-managed ECG-recordings to diagnose AF recurrence after cardioversion.
Clinical examination, echocardiography, ECG and blood sampling will be performed at baseline (0-6 weeks before cardioversion), 4-6 hours after cardioversion and 4 weeks after cardioversion. Between the time of the first visit and the follow-up visit 4 weeks after cardioversion, the patients will be instructed to record ECG by use of a Zenicor ® handheld ECG device twice daily and whenever they experience symptoms.
The variables to be investigated include novel echocardiographic indices, electrocardiographic parameters and plasma biomarkers reflecting coagulation, inflammation and fibrosis. The primary endpoint will be recurrence of ECG-documented AF after cardioversion, and time to recurrence will be registered.