Clinical utility of rhythm control by electrical cardioversion to assess the association between self-reported symptoms and rhythm status in patients with persistent atrial fibrillation
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Clinical utility of rhythm control by electrical cardioversion to assess the association between self-reported symptoms and rhythm status in patients with persistent atrial fibrillation. / Hermans, Astrid N. L.; Pluymaekers, Nikki A. H. A.; Lankveld, Theo A. R.; van Mourik, Manouk J. W.; Zeemering, Stef; Dinh, Trang; den Uijl, Dennis W.; Luermans, Justin G. L. M.; Vernooy, Kevin; Crijns, Harry J. G. M.; Schotten, Ulrich; Linz, Dominik.
I: IJC Heart and Vasculature, Bind 36, 100870, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Clinical utility of rhythm control by electrical cardioversion to assess the association between self-reported symptoms and rhythm status in patients with persistent atrial fibrillation
AU - Hermans, Astrid N. L.
AU - Pluymaekers, Nikki A. H. A.
AU - Lankveld, Theo A. R.
AU - van Mourik, Manouk J. W.
AU - Zeemering, Stef
AU - Dinh, Trang
AU - den Uijl, Dennis W.
AU - Luermans, Justin G. L. M.
AU - Vernooy, Kevin
AU - Crijns, Harry J. G. M.
AU - Schotten, Ulrich
AU - Linz, Dominik
PY - 2021
Y1 - 2021
N2 - Background: The best strategy to assess the association between symptoms and rhythm status (symptom-rhythm correlation) in patients with atrial fibrillation (AF) remains unclear. We aimed to determine the clinical utility of rhythm control by electrical cardioversion (ECV) to assess symptom-rhythm correlation in patients with persistent AF.Methods: We used ECV to examine symptom-rhythm correlation in 81 persistent AF patients. According to current clinical practice, the presence of self-reported symptoms before ECV and at the first outpatient clinic follow-up visit (within 1-month) was assessed to determine the prevalence of a symptom-rhythm correlation (defined as self-reported symptoms present during AF and absent in sinus rhythm or absent in AF and yet relief during sinus rhythm). In addition, we evaluated symptom patterns around ECV.Results: Only in 18 patients (22%), a symptom-rhythm correlation could be documented. Twenty-eight patients (35%) did not show any symptom-rhythm correlation and 35 patients (43%) had an unevaluable symptomrhythm correlation as these patients were in symptomatic AF both at baseline and at the first outpatient AF clinic follow-up visit. Importantly, self-reported symptom patterns around ECV were intra-individually variable in 10 patients (12%) without symptom-rhythm correlation (of which 9 patients (11%) had AF recurrence) and in 2 patients (2%) with an unevaluable symptom-rhythm correlation.Conclusions: In patients with persistent AF, symptom assessment around rhythm control by ECV, once before ECV and once within 1-month follow-up, rarely identifies a symptom-rhythm correlation and often suggests changes in symptom pattern. Better strategies are needed to assess symptom-rhythm correlation in patients with persistent AF.
AB - Background: The best strategy to assess the association between symptoms and rhythm status (symptom-rhythm correlation) in patients with atrial fibrillation (AF) remains unclear. We aimed to determine the clinical utility of rhythm control by electrical cardioversion (ECV) to assess symptom-rhythm correlation in patients with persistent AF.Methods: We used ECV to examine symptom-rhythm correlation in 81 persistent AF patients. According to current clinical practice, the presence of self-reported symptoms before ECV and at the first outpatient clinic follow-up visit (within 1-month) was assessed to determine the prevalence of a symptom-rhythm correlation (defined as self-reported symptoms present during AF and absent in sinus rhythm or absent in AF and yet relief during sinus rhythm). In addition, we evaluated symptom patterns around ECV.Results: Only in 18 patients (22%), a symptom-rhythm correlation could be documented. Twenty-eight patients (35%) did not show any symptom-rhythm correlation and 35 patients (43%) had an unevaluable symptomrhythm correlation as these patients were in symptomatic AF both at baseline and at the first outpatient AF clinic follow-up visit. Importantly, self-reported symptom patterns around ECV were intra-individually variable in 10 patients (12%) without symptom-rhythm correlation (of which 9 patients (11%) had AF recurrence) and in 2 patients (2%) with an unevaluable symptom-rhythm correlation.Conclusions: In patients with persistent AF, symptom assessment around rhythm control by ECV, once before ECV and once within 1-month follow-up, rarely identifies a symptom-rhythm correlation and often suggests changes in symptom pattern. Better strategies are needed to assess symptom-rhythm correlation in patients with persistent AF.
KW - Atrial fibrillation
KW - Electrical cardioversion
KW - Symptom-rhythm correlation
KW - CATHETER ABLATION
KW - ARTERIAL STIFFNESS
KW - BURDEN
U2 - 10.1016/j.ijcha.2021.100870
DO - 10.1016/j.ijcha.2021.100870
M3 - Journal article
C2 - 34568541
VL - 36
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
SN - 2352-9067
M1 - 100870
ER -
ID: 286423449