Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy

Łukasz Turek; Marcin Sadowski; Agnieszka Janion-Sadowska; Jacek Kurzawski; Szymon Domagała; Marianna Janion

doi:10.5114/ms.2022.122383

eISSN: 2300-6722
ISSN: 1899-1874

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abstract:

Original paper

Recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy

Łukasz Turek

¹

,

Marcin Sadowski

¹

,

Agnieszka Janion-Sadowska

¹

,

Jacek Kurzawski

¹

,

Szymon Domagała

¹

,

Marianna Janion

¹

Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland Head of the Institute: Beata Kręcisz MD, PhD, Prof. JKU

Medical Studies/Studia Medyczne 2022; 38 (4): 273–286

DOI: https://doi.org/10.5114/ms.2022.122383

Online publish date: 2022/12/16

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AMA

Turek Ł, Sadowski M, Janion-Sadowska A, Kurzawski J, Domagała S, Janion M. Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy. Medical Studies/Studia Medyczne. 2022;38(4):273-286. doi:10.5114/ms.2022.122383.

APA

Turek, Ł., Sadowski, M., Janion-Sadowska, A., Kurzawski, J., Domagała, S.,  & Janion, M. (2022). Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy. Medical Studies/Studia Medyczne, 38(4), 273-286. https://doi.org/10.5114/ms.2022.122383

Chicago

Turek, Łukasz, Marcin Sadowski, Agnieszka Janion-Sadowska, Jacek Kurzawski, Szymon Domagała,  and Marianna Janion. 2022. "Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy". Medical Studies/Studia Medyczne 38 (4): 273-286. doi:10.5114/ms.2022.122383.

Harvard

Turek, Ł., Sadowski, M., Janion-Sadowska, A., Kurzawski, J., Domagała, S.,  and Janion, M. (2022). Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy. Medical Studies/Studia Medyczne, 38(4), pp.273-286. https://doi.org/10.5114/ms.2022.122383

MLA

Turek, Łukasz et al. "Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy." Medical Studies/Studia Medyczne, vol. 38, no. 4, 2022, pp. 273-286. doi:10.5114/ms.2022.122383.

Vancouver

Turek Ł, Sadowski M, Janion-Sadowska A, Kurzawski J, Domagała S, Janion M. Recurrence of arrhythmia and adverse cardiovascular events
within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy. Medical Studies/Studia Medyczne. 2022;38(4):273-286. doi:10.5114/ms.2022.122383.

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Introduction
Patients with atrial fibrillation (AF) are at increased risk of cardiovascular diseases and death. Evidence on the comparable effects of rhythm and heart rate control strategies in patients with AF is ambiguous.

Aim of the research
To assess the recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with AF receiving oral anticoagulation therapy.

Material and methods
This was a prospective, single-centre cohort study. The participants underwent transoesophageal echocardiography before direct current cardioversion (DCC). A total of 226 patients were enrolled. The primary outcome was sinus rhythm (SR) restoration after DCC for AF. All participants were followed up for 12 months to evaluate the incidence of death, systemic thromboembolic events, stroke, acute coronary syndrome, hospitalization due to worsening heart failure (HF), and recurrence of arrhythmia after SR restoration.

Results
SR restoration was achieved after DCC in 197 (87.2 %) patients, of whom 112 (56.9%) experienced arrhythmia relapse. Significant risk factors associated with arrhythmia recurrence were -adrenergic antagonist therapy, chronic obstructive pulmonary disease, and previous stroke/transient ischaemic attack/thromboembolic events. All enrolled patients were free of acute coronary syndrome, systemic thromboembolic events, and stroke, and none of the patients died during the 12-month follow-up period. Hospitalization with worsening HF occurred in 13 patients with SR and in 10 patients with persistent AF (p = 0.42).

Conclusions
The arrhythmia recurrence rate was high; however, cardiovascular complications and deaths did not occur. The incidence of hospitalization for HF was comparable between the AF and SR groups.

keywords:

Recurrence of arrhythmia and adverse cardiovascular events within 12 months of electrical cardioversion in patients with atrial fibrillation receiving oral anticoagulation therapy

Łukasz Turek 1 , Marcin Sadowski 1 , Agnieszka Janion-Sadowska 1 , Jacek Kurzawski 1 , Szymon Domagała 1 , Marianna Janion 1

atrial fibrillation, anticoagulation, transoesophageal echocardiography, electrical cardioversion, stroke

Łukasz Turek

¹

,

Marcin Sadowski

¹

,

Agnieszka Janion-Sadowska

¹

,

Jacek Kurzawski

¹

,

Szymon Domagała

¹

,

Marianna Janion

¹