Background: Atrial fibrillation (AF) is a prevalent arrhythmic condition that affects millions of individuals across the globe. Direct current cardioversion (DCCV) is frequently utilized to restore sinus rhythm, but its long-term success rates are not optimal. Recent meta-analysis has concluded pre-treatment with anti-arrhythmic drugs improves acute restoration and maintenance of sinus rhythm after electrical cardioversion. This study aims to investigate whether the efficacy of anti-arrhythmic drugs, particularly amiodarone, in promoting sinus rhythm in patients with AF who have undergone elective DCCV in our centre, is consistent with the results in recent meta-analysis.
Methods: This is a retrospective, single-centre analysis of patients with persistent AF for elective DCCV between January 2022 and March 2023. Patient demographics, medical history, and pharmacologic information were obtained from data record of DCCV clinic. Echocardiographic data, such as left atrial diameter and left ventricular systolic function, were also analyzed.
Results: The outcome indicates no significant correlation between the use of AADs and successful DCCV. No association was found between AAD types, AF risk factors, associated comorbidities, LVEF, LA size and the success of DCCV. However, Chi-Square tests indicate a potential connection between high BMI and success rates in cardioversion, but further research is necessary to determine its significance. According to the group statistics, there is a noticeable difference in the duration of AF (in weeks) between the success rates of DCCV. However, AADs did not have an impact on this difference.
Conclusion: The results indicate no significant correlation between the use of AADs and successful DCCV, which is inconsistent with recent meta-analysis. However, we noticed a significant correlation between the duration of AF and the success rates of DCCV, but AADs did not impact this difference. Further research would be beneficial in determining its significance. ❑
C-Y Chan and P Aung are co-first authors
