Cardioversion

In patients where atrial fibrillation (AF) has been present a short time, the optimal method to restore sinus rhythm (SR) is cardioversion. However, the natural prognosis of AF is that it worsens over time. Paroxysmal episodes of AF increases in frequency and duration to eventually give way to persistent or permanent AF. Despite the progress in characterizing atrial depolarization in great detail, some important issues are still not completely understood. Decision-making parameters influencing the therapeutic roadmap for AF patients are still lacking. The normal therapeutic goal is to restore sinus rhythm in an early stage before the AF progresses too far and chances of successful restoration of SR has been reduced. Hence, a predictor for maintenance of SR following cardioversion is coveted. Such a predictor would guide physicians to decide whether to put the patient through cardioversion or alternative therapy. A priori knowledge of the most efficient treatment for AF patients is crucial to reduce hospital costs and patient inconvenience.

The Atrial Fibrillation Rate (AFR) is an indicator of the atrial disorganization caused by the AF. It has been shown that there is a correlation between long term success for patients to remain in SR after cardioversion of AF, and a threshold value of the AFR [1]. 

This observation is more evident in patients with short duration AF rather that long duration AF, which comes from natural reasons stated above. Previous and ongoing clinical studies have defined patient groups where the AFR value is a predictor for successful cardioversion.   

Please click here to read more about the AFR threshold value identified in  [1].