Cardiology Letters 2016, 25(3):163-172
The management of patients with persistent atrial fibrillation
- Kardiocentrum FNsP J. A. Reimana v Prešove, Slovenská republika
The management of patients with atrial fibrillation (AF) is focused on a reduction of symptoms and the prevention of severe complications associated with AF.
Aim: Analysis of the management of patients with persistent atrial fibrillation.
Methods: Retrospective analysis of a selected cohort of 108 patients with persistent AF (45.37% males, 54.63% women) who were hospitalized at the University Hospital Cardiocenter J.A. Reiman in Prešov in the period of 1st July 2014 to 31st December 2014 for the treatment of atrial fibrillation.
Results: During the file analysis, we found more patients indicated initially for electrical than for pharmacological cardioversion (78.7% and 21.3%; respectively, p=0.6378), fewer patients indicated initially for acute than for postponed cardioversion (39.8% and 60, 2%; respectively, p=0.5615). A transoesophageal echocardiography examination was performed in 21.29% of patients. The overall success rate was 93.52% cardioversion (CV). A statistically significant difference between the electrical and pharmacological (CV) was not observed. The percentage of cardioversion in patients with a duration of AF ≤ 48 hours was 97.22%, and duration AF > 48 hours 91.66%. Statistical significance was not achieved even in terms of gender (p=0.4022) or in terms of the success of the cardioversion (p=0.8843). In the analysis of the number of successful cardioversion relapses AF a statistically significant difference was recorded in the success of cardioversion in patients with a first attack of AF in comparison with patients with more than three relapses (93.75% and 85.71%; respectively, p=0.0005) and patients with a first relapse versus AF success in patients with more than three relapses (100% and 85.71; respectively, p<0,0001). Overall, we observed complications in 15.74% of patients, which did not lead to a serious anesthesiology or cardiac complications.
Conclusion: Management of AF includes a strategy of ventricular rate control, restoration and maintenance of sinus rhythm and prevention of stroke.
Keywords: atrial fibrillation; sinus rhythm; cardioversion
Published: March 1, 2016 Show citation
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