Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation
Atrial fibrillation (AF) is the most frequent chronic arrhythmia worldwide, and it is associated with significant morbidity and mortality, making it a considerable burden both to patients and the healthcare system. Nowadays, an early attempt to restore sinus rhythm in acute symptomatic AF through el...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/11/1513 |
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| author | Marco Valerio Mariani Nicola Pierucci Agostino Piro Sara Trivigno Cristina Chimenti Gioacchino Galardo Fabio Miraldi Carmine Dario Vizza |
| author_facet | Marco Valerio Mariani Nicola Pierucci Agostino Piro Sara Trivigno Cristina Chimenti Gioacchino Galardo Fabio Miraldi Carmine Dario Vizza |
| author_sort | Marco Valerio Mariani |
| collection | DOAJ |
| description | Atrial fibrillation (AF) is the most frequent chronic arrhythmia worldwide, and it is associated with significant morbidity and mortality, making it a considerable burden both to patients and the healthcare system. Nowadays, an early attempt to restore sinus rhythm in acute symptomatic AF through electrical or pharmacological cardioversion is the most common approach in the Emergency Department (ED). However, considering the high percentage of spontaneous cardioversion of paroxysmal AF reported by many studies, this approach may not be the ideal choice for all patients. In this manuscript we performed a review of the most relevant studies found in literature with the aim of identifying the main determinants of spontaneous cardioversion, focusing on those easy to detect in the ED. We have found that the most relevant predictors of spontaneous cardioversion are the absence of Heart Failure (HF), a small atrial size, recent-onset AF, rapid Atrial Fibrillatory Rate and the relationship between a previous AF episode and Heart Rate/Blood Pressure. A number of those are utilized, along with other easily determined parameters, in the recently developed “ReSinus” score which predicts the likelihood of AF spontaneous cardioversion. Such identification may help the physician decide whether immediate cardioversion is necessary, or whether to adopt a “watch-and-wait” strategy in the presence of spontaneous cardioversion determinants. |
| first_indexed | 2024-03-09T18:52:07Z |
| format | Article |
| id | doaj.art-a5f45fefbe9046aeac85a5ed45d9f83f |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T18:52:07Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-a5f45fefbe9046aeac85a5ed45d9f83f2023-11-24T05:46:03ZengMDPI AGMedicina1010-660X1648-91442022-10-015811151310.3390/medicina58111513Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial FibrillationMarco Valerio Mariani0Nicola Pierucci1Agostino Piro2Sara Trivigno3Cristina Chimenti4Gioacchino Galardo5Fabio Miraldi6Carmine Dario Vizza7Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyMedical Emergency Unit, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyAtrial fibrillation (AF) is the most frequent chronic arrhythmia worldwide, and it is associated with significant morbidity and mortality, making it a considerable burden both to patients and the healthcare system. Nowadays, an early attempt to restore sinus rhythm in acute symptomatic AF through electrical or pharmacological cardioversion is the most common approach in the Emergency Department (ED). However, considering the high percentage of spontaneous cardioversion of paroxysmal AF reported by many studies, this approach may not be the ideal choice for all patients. In this manuscript we performed a review of the most relevant studies found in literature with the aim of identifying the main determinants of spontaneous cardioversion, focusing on those easy to detect in the ED. We have found that the most relevant predictors of spontaneous cardioversion are the absence of Heart Failure (HF), a small atrial size, recent-onset AF, rapid Atrial Fibrillatory Rate and the relationship between a previous AF episode and Heart Rate/Blood Pressure. A number of those are utilized, along with other easily determined parameters, in the recently developed “ReSinus” score which predicts the likelihood of AF spontaneous cardioversion. Such identification may help the physician decide whether immediate cardioversion is necessary, or whether to adopt a “watch-and-wait” strategy in the presence of spontaneous cardioversion determinants.https://www.mdpi.com/1648-9144/58/11/1513atrial fibrillationspontaneous cardioversionantiarrhythmic therapy |
| spellingShingle | Marco Valerio Mariani Nicola Pierucci Agostino Piro Sara Trivigno Cristina Chimenti Gioacchino Galardo Fabio Miraldi Carmine Dario Vizza Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation Medicina atrial fibrillation spontaneous cardioversion antiarrhythmic therapy |
| title | Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation |
| title_full | Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation |
| title_fullStr | Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation |
| title_full_unstemmed | Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation |
| title_short | Incidence and Determinants of Spontaneous Cardioversion of Early Onset Symptomatic Atrial Fibrillation |
| title_sort | incidence and determinants of spontaneous cardioversion of early onset symptomatic atrial fibrillation |
| topic | atrial fibrillation spontaneous cardioversion antiarrhythmic therapy |
| url | https://www.mdpi.com/1648-9144/58/11/1513 |
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