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Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial.

Cappato, R; Ezekowitz, MD; Hohnloser, SH; Meng, IL; Wosnitza, M; Camm, AJ (2021) Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial. Europace, 23 (10). pp. 1539-1547. ISSN 1532-2092 https://doi.org/10.1093/europace/euab084
SGUL Authors: Camm, Alan John

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Abstract

AIMS: Using a pre-planned post hoc analysis of patients included in X-VeRT, we evaluated predictors of sinus rhythm at 6 weeks after planned cardioversion. METHODS AND RESULTS: Receiver operating characteristic curves and logistic regression models were used to evaluate continuous and categorical variables as predictors of sinus rhythm 6 at weeks from cardioversion (end of study). The primary analysis was performed in successfully cardioverted patients with an evaluable electrocardiogram at end of study. A second analysis evaluated additional patients who spontaneously restored sinus rhythm before planned cardioversion. Of the 1504 patients with atrial fibrillation of >48 h or of unknown duration who were randomly assigned to either rivaroxaban or vitamin K antagonist, 1039 (64.6 ± 10.3 years, 73.4% male) underwent planned cardioversion and were included in this study. Patients receiving early cardioversion (i.e. between 1 and 5 days from hospitalization) had a 67% higher probability to have sinus rhythm at end of study than those who received delayed cardioversion (i.e. between 21 and 56 days from hospitalization) [odds ratio (OR) 1.67, confidence interval (CI) 1.27-2.18; P < 0.0001]. In a multivariate analysis of 17 baseline variables, patients with a CHADS2 score of 0 were 33% less likely to be in sinus rhythm than those with a CHADS2 score ≥2 (OR 0.66, CI 0.47-0.94; P = 0.0225). In the secondary analysis, spontaneous restoration of sinus rhythm was also found to predict sinus rhythm at end of study (OR 8.62, CI 1.54-48.16; P = 0.0142). CONCLUSION: In X-VeRT, early cardioversion and high CHADS2 scores predicted sinus rhythm at 6 weeks from cardioversion.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in EP Europace following peer review. The version of record Riccardo Cappato, Michael D Ezekowitz, Stefan H Hohnloser, Isabelle Ling Meng, Melanie Wosnitza, , and Arthur John Camm, the X-VeRT Steering Committee and Investigators, Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial, EP Europace, Volume 23, Issue 10, October 2021, Pages 1539–1547 is available online at: https://doi.org/10.1093/europace/euab084
Keywords: Atrial fibrillation, Cardioversion, Rivaroxaban, Sinus rhythm predictors, X-VeRT study, Atrial fibrillation, Cardioversion, Rivaroxaban, Sinus rhythm predictors, X-VeRT study, Cardiovascular System & Hematology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Europace
ISSN: 1532-2092
Language: eng
Dates:
DateEvent
October 2021Published
13 June 2021Published Online
22 March 2021Accepted
Publisher License: Publisher's own licence
PubMed ID: 34128075
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113386
Publisher's version: https://doi.org/10.1093/europace/euab084

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