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Is electrical cardioversion independently associated with infarcts on brain magnetic resonance imaging or clinical outcomes in patients with atrial fibrillation?
Stauber, Annina; Müller, Andreas; Rommers, Nikki; Aeschbacher, Stefanie; Bonati, Leo H; Conen, David; Reichlin, Tobias; Ammann, Peter; Rodondi, Nicolas; DiValentino, Marcello; Moschovitis, Giorgio; Aebersold, Helena; Beer, Jürg Hans; Sinnecker, Tim; Jeger, Raban V; Kurz, David J; Liedtke, Claudia; Kühne, Michael; Osswald, Stefan; Bernheim, Alain M.
Afiliación
  • Stauber A; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland.
  • Müller A; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland.
  • Rommers N; Department of Clinical Research, University of Basel, Basel, Switzerland.
  • Aeschbacher S; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
  • Bonati LH; Division of Neurology and Stroke Centre, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Research, Rehabilitation Clinic Rheinfelden, Rheinfelden, Switzerland.
  • Conen D; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Reichlin T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Ammann P; Department of Cardiology, Kantonsspital St Gallen, St Gallen, Switzerland.
  • Rodondi N; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • DiValentino M; Department of Cardiology, Ospedale San Giovanni, Bellinzona, Switzerland.
  • Moschovitis G; Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland.
  • Aebersold H; Department of Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland.
  • Beer JH; Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital Zurich, Zurich, Switzerland.
  • Sinnecker T; Division of Neurology and Stroke Centre, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
  • Jeger RV; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland.
  • Kurz DJ; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland.
  • Liedtke C; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland.
  • Kühne M; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland; Division of Cardiology, Department of Medicine, University of Basel, Basel, Switzerland.
  • Osswald S; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland; Division of Cardiology, Department of Medicine, University of Basel, Basel, Switzerland.
  • Bernheim AM; Department of Cardiology, Stadtspital Zurich Triemli, Zurich, Switzerland. Electronic address: alain.bernheim@stadtspital.ch.
Heart Rhythm ; 2024 Jul 19.
Article en En | MEDLINE | ID: mdl-39177518
ABSTRACT

BACKGROUND:

Electrical cardioversion (ECV) is frequently performed in symptomatic atrial fibrillation.

OBJECTIVE:

This study aimed to assess the association of ECV with infarcts on brain magnetic resonance imaging (bMRI) and clinical outcomes.

METHODS:

The Swiss Atrial Fibrillation Cohort Study included 2386 patients; 1731 patients were evaluated by bMRI. ECVs were recorded by questionnaire. Patients were assigned to categories by number of ECVs performed before enrollment (0, 1, ≥2). A bMRI study was conducted at baseline and after 2 years (n = 1227) and analyzed for large noncortical or cortical infarcts and small noncortical infarcts. Clinical outcomes were recorded during follow-up. Associations of ECV and outcome measures were assessed by multivariate analyses.

RESULTS:

There was no independent association between the number of ECVs and infarct prevalence (large noncortical or cortical infarcts and small noncortical infarcts) on baseline bMRI (ECV 1 vs 0 odds ratio [OR], 0.95 [95% CI, 0.68-1.24]; ECV ≥2 vs 0 OR, 1.04 [0.72-1.44]) or between ECVs performed during follow-up and new infarcts on bMRI at 2 years (OR, 1.46 [0.54-3.31]). ECVs were not associated with overt stroke or transient ischemic attack (ECV 1 vs 0 hazard ratio [HR], 1.36 [0.88-2.10]; ECV ≥2 vs 0 HR, 1.53 [0.94-2.48]), hospitalization for heart failure (ECV 1 vs 0 HR, 1.06 [0.82-1.37]; ECV ≥2 vs 0 HR, 1.03 [0.77-1.38]), or death (ECV 1 vs 0 HR, 0.90 [0.70-1.15]; ECV ≥2 vs 0 HR, 0.91 [0.69-1.20]).

CONCLUSION:

There was no association between ECV performed before enrollment and cerebral infarcts on baseline bMRI or between ECV performed during follow-up and new infarcts at 2 years. Moreover, ECV was not associated with clinical events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heart Rhythm Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heart Rhythm Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos