Arrhythmias & electrophysiology
Is electrical cardioversion independently associated with infarcts on brain magnetic resonance imaging or clinical outcomes in patients with atrial fibrillation?
Authors' 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.
Study context
- Population
- Patients with AF in the Swiss Atrial Fibrillation Cohort Study1,731 evaluated by brain magnetic resonance imaging (bMRI)
- Participants
- 2,386 patients
- Exposure
- Number of electrical cardioversion (ECVs) vs 0
- Outcome
- Infarcts on brain MRI (large noncortical or cortical and small noncortical infarcts) and clinical outcomes
- Follow-up
- Baseline and 2 years
Methodological detailsmultivariate analyses, ECVs recorded by questionnaire
- Multivariate analyses
- ECVs recorded by questionnaire
Main finding
As reported in the abstract
Infarct prevalence on baseline bMRI
Each group vs ECV 0Odds ratio (95% CI)
ECV 1
0.95(0.68–1.24)
ECV ≥2
1.04(0.72–1.44)
Observational data: associations, not effects.
Further findings
New infarcts on bMRI with ECVs during follow-up · 2 years
| OR (CI) | ||
|---|---|---|
| ECV during follow-upn = 1227 with 2-year bMRI | 1.46 (0.54–3.31) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | HR (CI) | |
|---|---|---|
| Overt stroke or TIAECV 1vs ECV 0 | 1.36 (0.88–2.10) | |
| Overt stroke or TIAECV ≥2vs ECV 0 | 1.53 (0.94–2.48) | |
| Hospitalization for HFECV 1vs ECV 0 | 1.06 (0.82–1.37) | |
| Hospitalization for HFECV ≥2vs ECV 0 | 1.03 (0.77–1.38) | |
| DeathECV 1vs ECV 0 | 0.90 (0.70–1.15) | |
| DeathECV ≥2vs ECV 0 | 0.91 (0.69–1.20) | |
| 0.512Hazard ratio (log scale) |
Original publication
Is electrical cardioversion independently associated with infarcts on brain magnetic resonance imaging or clinical outcomes in patients with atrial fibrillation? Heart Rhythm. Published 23 August 2024. doi:10.
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