14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-180

Safety and effectiveness of a stepwise procedure for the treatment of atrial fibrillation based on clinical and echocardiographic criteria

Alessandro Carunchio, Luciano Pandolfo, Maurizio Burattini, Claudio Coletta, Andrea Porzio, Maria Margherita Martinelli, Alessandro Danesi, Vincenzo Ceci.
Cardiology division, Santo Spirito Hospital, Rome, Italy

Background

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in the clinical practice. Its prevalence increases with age and with structural cardiac disease¹. Hypertensive heart disease is most frequently associated with atrial fibrillation because of reduction of rheumatic valvular disease². Hemodynamic deterioration with dyspnea, heart failure and angina or palpitations, dizziness and fatigue are frequently presents at the beginning of AF^3-5.

AF has a significant impact on longevity, approximately doubling overall and cardiovascular mortality rates⁶. Furthermore, AF constitutes a major independent risk factor for stroke, with a 3 to 5 fold increased risk after adjusting for other risk factors; 70% of all embolic events are represented by stroke. SPINAF (Stroke Prevention in Nonrheumatic Atrial Fibrillation) study⁷ documented a prevalence of silent cerebral infarct of 14.7% of patients with nonrheumatic AF and Feinberg et al⁸ referred a prevalence ranging from 28 to 48%.

Indeed, any attempt to restore a sinus rhythm is mandatory, if not unsuitable, also in case of AF recurrence.

Aim of the study was to verify the safety and effectiveness of a cardioversion procedure for the treatment of patients (pts) with AF based on clinical and echocardiographic data.