Predicting Unsuccessful Electrical Cardioversion for Acute Atrial Fibrillation Interview with:
Juhani Airaksinen, MD, PhD

Professor, Chief of Cardiology
Directork Heart Center
Turku University Hospital What is the background for this study? What are the main findings?

Response: Electrical cardioversion (ECV) is an essential part of rhythm control strategy in patients with paroxysmal atrial fibrillation (AF). There is limited information on unsuccessful outcome of ECV (i.e. failure of cardioversion or early recurrence of AF) for acute AF. Our study shows that the risk of unsuccessful outcome of ECV can be predicted using five simple clinical variables. These variables were used to derivate and validate a novel risk stratification tool (the AF-CVS Score) for predicting unsuccessful ECV outcome. Study patients with high AF-CVS Score points (>5) had a high incidence of ECV failure or early AF recurrence. What should readers take away from your report?

Response: Careful evaluation of the management strategy of AF should be carried out for each patient presenting to the emergency room with acute AF to avoid repeated and ineffective cardioversions. The AF-CVS Score can be used to evaluate the individual risk of unsuccessful outcome of ECV. What recommendations do you have for future research as a result of this study?

Response: The AF-CVS Score should be further validated in different populations. Is there anything else you would like to add?

Response: Each cardioversion – even in the acute setting – predisposes the patient to thromboembolic complications when performed without adequate anticoagulation. Another important assessment before an ECV is the thromboembolic risk of the patient. Thank you for your contribution to the community.


Predicting Unsuccessful Electrical Cardioversion for Acute Atrial Fibrillation (From the AF-CVS Score)
Samuli Jaakkola, Gregory Y.H. Lip, Fausto Biancari, Ilpo Nuotio, Juha E.K. Hartikainen, Antti Ylitalo, K. E. Juhani Airaksinen

December 02, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on December 9, 2016 by Marie Benz MD FAAD