Is electrical cardioversion independently associated with infarcts on brain magnetic resonance imaging or clinical outcomes in patients with atrial fibrillation?

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-01-01 DOI:10.1016/j.hrthm.2024.06.026

Annina Stauber MD , Andreas Müller MD , Nikki Rommers PhD , Stefanie Aeschbacher PhD , Leo H. Bonati MD , David Conen MD, MPH , Tobias Reichlin MD , Peter Ammann MD , Nicolas Rodondi MD , Marcello DiValentino MD , Giorgio Moschovitis MD , Helena Aebersold PhD , Jürg Hans Beer MD , Tim Sinnecker MD , Raban V. Jeger MD , David J. Kurz MD , Claudia Liedtke BSN , Michael Kühne MD , Stefan Osswald MD , Alain M. Bernheim MD

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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.

Abstract Image

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电复律与心房颤动患者脑磁共振成像上的梗塞或临床预后是否有独立关联？

背景：电除颤术（ECV）经常用于有症状的心房颤动：电复律（ECV）经常用于有症状的心房颤动：本研究旨在评估电复律与脑磁共振成像（bMRI）脑梗塞和临床结果之间的关系：瑞士心房颤动队列研究共纳入 2386 名患者，其中 1731 名患者接受了脑磁共振成像评估。心电图通过问卷调查进行记录。根据入组前进行的心电图次数（0、1、≥2）对患者进行分类。在基线和 2 年后进行了 bMRI 研究（n = 1227），分析了大面积非皮质或皮质梗死以及小面积非皮质梗死。随访期间记录了临床结果。通过多变量分析评估了ECV与结果测量的相关性：基线 bMRI 上的 ECV 数量与梗死发生率（大的非皮质或皮质梗死和小的非皮质梗死）之间没有独立关联（ECV 1 vs 0：几率比 [OR], 0.95[95%CI，0.68-1.24]；ECV ≥2 vs 0：OR，1.04 [0.72-1.44]），或随访期间进行的 ECV 与 2 年后 bMRI 新发梗死之间（OR，1.46 [0.54-3.31]）。ECV与明显中风或短暂性脑缺血发作无关（ECV 1 vs 0：危险比 [HR]，1.36 [0.88-2.10]；ECV ≥2 vs 0：HR，1.53 [0.94-2.48]）。48]）、因心力衰竭住院（ECV 1 vs 0：HR，1.06 [0.82-1.37]；ECV ≥2 vs 0：HR，1.03 [0.77-1.38]）或死亡（ECV 1 vs 0：HR，0.90 [0.70-1.15]；ECV ≥2 vs 0：HR，0.91 [0.69-1.20]）：结论：入组前进行的ECV与基线bMRI显示的脑梗死之间没有关联，随访期间进行的ECV与2年后新发脑梗死之间也没有关联。此外，ECV 也与临床事件无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.