ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024
Failure of intravenous nifekalant cardioversion as an independent predictor for persistent atrial fibrillation recurrence after catheter ablation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors at 2 institutions in 1 country.
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Abstract
aimsNifekalant is a class III antiarrhythmic drug that exerts antiarrhythmic effects by inhibiting rapid rectifying potassium channels and extending the effective refractory period of cardiomyocytes. It has a high success rate in converting atrial fibrillation (AF) to sinus rhythm. Whether the failure of intravenous nifekalant cardioversion is an independent predictor for persistent AF recurrence after catheter ablation has not been reported.
methodsA total of 92 patients with drug-refractory persistent AF were retrospectively enrolled. After all ablations, intravenous nifekalant was administrated. Patients were assigned to the success group (group 1) and failure group (group 2) based on nifekalant cardioversion results and followed for 12 months to note any episode of atrial arrhythmia recurrence.
resultsEach group included 46 patients. After 12 months of follow-up, nine (19.6%) patients from group 1 and 23 (50.0%) patients from group 2 had a recurrence of atrial tachyarrhythmia (P = 0.002). AF duration and type 2 diabetes were strongly associated with failure of intravenous nifekalant cardioversion. Univariable Cox proportional hazard regression showed that failure of intravenous nifekalant cardioversion, AF duration, and type 2 diabetes were potential risk factors. Multivariable Cox proportional hazard regression showed that failure of nifekalant cardioversion was statistically associated with AF recurrence (adjusted RR = 2.257, 95% CI: 1.006-5.066, P = 0.048). Failure of intravenous nifekalant cardioversion could bring a positive effect on the prognostic differentiation when added into the multivariable model (0.767 ± 0.042 vs. 0.774 ± 0.045, P = 0.025).
conclusionFailure of nifekalant cardioversion is an independent predictor for persistent AF recurrence after catheter ablation.
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