| Does sinus rhythm beget sinus rhythm? Effects of prompt cardioversion on the frequency and persistence of recurrent atrial fibrillation. | |
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MedLine Citation:
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PMID: 15071254 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recent clinical and experimental studies have demonstrated that atrial fibrillation (AF) alters the electrical and mechanical remodeling of the atrium, which subsequently promote the maintenance and recurrence of AF. If atrial remodeling can be prevented with prompt and repeated cardioversion, the likelihood of AF recurrence may be reduced. Recent clinical studies have demonstrated that the strategies of transesophageal echocardiography facilitated early cardioversion and early repeated cardioversion may be clinically valuable in some patients who have persistent AF and recurrence of arrhythmia after the initial cardioversion. Furthermore, the use an implantable atrial defibrillator (IAD) for early repeated device-based cardioversion to maintain sinus rhythm appears to be safe and clinically feasible. Early cardioversion by IAD reduces AF burden, reverses atrial remodeling and prevents subsequent AF recurrence in selected patients without structural heart disease implanted with this device, indicating possible "sinus rhythm begets sinus rhythm". Despite encouraging initial observations, further long-term clinical studies in a larger patient population are needed to confirm this finding. Furthermore, whether the use of IAD in the fully automatic mode to provide immediate termination of AF episodes could intensify the potential beneficial effect and the clinical efficacy of this approach in patients with structural heart disease needs to be evaluated. |
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Authors:
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Hung-Fat Tse; Chu-Pak Lau |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Cardiac electrophysiology review Volume: 7 ISSN: 1385-2264 ISO Abbreviation: Card Electrophysiol Rev Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2004-04-08 Completed Date: 2004-08-26 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 9708907 Medline TA: Card Electrophysiol Rev Country: United States |
Other Details:
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Languages: eng Pagination: 359-65 Citation Subset: IM |
Affiliation:
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Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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physiopathology,
prevention & control*,
ultrasonography Defibrillators, Implantable* Disease Progression Echocardiography, Doppler, Pulsed Echocardiography, Transesophageal Electric Countershock* Heart Atria / physiopathology Humans Recurrence / prevention & control Retreatment Signal Transduction / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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