How to Predict Spontaneous Conversion of Afib to Sinus Rhythm

Patients with atrial fibrillation (AF) of less than 48 hours' duration have a very high rate of spontaneous conversion (SC) to sinus rhythm (SR). What . . .

Patients with atrial fibrillation (AF) of less than 48 hours' duration have a very high rate of spontaneous conversion (SC) to sinus rhythm (SR). What about patients with AF of longer duration? To answer this question, researchers studied data from 1041 patients with AF of >48 hours' duration (range, 2 to 453 days) who were not receiving antiarrhythmic drug therapy upon enrollment in a multicenter, randomized trial that compared 2 anticoagulation strategies before electrical cardioversion: a transesophageal echocardiography (TEE)-guided approach with short-term anticoagulation; and a conventional anticoagulation strategy.

Of the 1041 subjects, 16% experienced SC to SR (21% in the conventional group vs. 11% in the TEE-guided group). Multivari…

Reviewing Author

Hugh Calkins, MD