Outpatient electrical cardioversion of atrial fibrillation: Efficacy, safety and patients' quality of life

Anatomical remodeling of left atria in subjects with chronic and paroxysmal atrial fibrillation evaluated by multislice computed tomography

“…In the medical treatment for Af, there is controversy over whether rhythm control or heart rate control is better for the patients' prognosis [12][13][14][15][16], while in fact, generally speaking, there is no significant difference between them. If the findings of the anatomical remodeling, highlighted by us in this study, are accepted as one of the indicators of the presence of an advanced anatomical form of CAf, then further stratification of the staging of Af may be achievable.…”

Outpatient Electrical Cardioversion of Atrial Fibrillation: 8 Years’ Experience. Analysis of Shock‐Related Arrhythmias

“…An important goal of clinicians is to restore sinus rhythm (SR), using drugs or electrical cardioversion, in order to avoid electrical remodelling of the atria, to preserve cardiac performance, and to prevent the potential risks of chronic anticoagulation therapy. Electrical cardioversion (EC) is a well‐established method for restoring SR and nowadays outpatient EC is the standard of care 3–5 . However, arrhythmic complications, generally shock‐related, have occasionally been described, even recently, and these may be particularly deleterious in this setting.…”

Responsiveness of AF6, a new, short, validated, atrial fibrillation-specific questionnaire—symptomatic benefit of direct current cardioversion

“…While direct current DC has long been an effective treatment for terminating persistent AF [1, 4, 5], presently available pharmacological options have not been very effective in maintaining patients in long-term SR, nor have they been as safe or tolerable as would be desired. Immediately after restoration to SR, symptom relief and improvement of HRQL represent the improvements that patients expect; but with long-term maintenance of SR, signs of reverse remodeling can be observed [7–9, 21–26].…”

“…The symptoms often have an impact on their health-related quality of life (HRQL) [1–3] and frequently cause patients to seek medical help. As symptoms in AF are so diverse, it may be difficult to estimate whether an individual patient would benefit symptomatically from a treatment attempt, e.g., cardioversion [4, 5]. No single symptom is truly AF specific, however, and almost any of the symptoms could also be caused by a concomitant condition.…”