Observational studyJournal of cardiovascular electrophysiology2025
Prognostic Impact of Spontaneous Conversion to Sinus Rhythm in Patients With Symptomatic Paroxysmal Atrial Fibrillation: A Propensity-Matched Follow-Up Study.
Observational study in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The trial behind it
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Who cites it
4 citing papers in PubMed.
- The Predictors of New-Onset Atrial Fibrillation in End-Stage Renal Disease Patients: A Multi-Center Retrospective Observational Study.Journal of clinical medicine · 2026Article
- Prognostic Value of SII for Prediction of Pharmacological Cardioversion Success in Newly Diagnosed Atrial Fibrillation.Journal of clinical medicine · 2026Article
- A Prospective Cohort Study on the Impact of SGLT2 Inhibitors on the 12‑Month Recurrence Risk of Atrial Fibrillation After Catheter Ablation.Drug design, development and therapy · 2026Observational
- Prognostic Impact of Spontaneous Conversion to Sinus Rhythm in Patients With Symptomatic Paroxysmal Atrial Fibrillation: A Propensity-Matched Follow-Up Study.Journal of cardiovascular electrophysiology · 2025Observational
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundParoxysmal atrial fibrillation (PAF) patients do not invariably progress to persistent AF, with a consistent group of patients showing AF regression during follow-up. The prognostic implications of spontaneous conversion (SCV) to sinus rhythm (SR) in those patients has never been evaluated yet.
objectiveTo evaluate the long-term prognostic impact of early SCV to SR in patients presenting with symptomatic, hemodynamically stable, PAF in the emergency department (ED).
methodsConsecutive patients with symptomatic, hemodynamically stable PAF were included. Patients discharged in SR and followed-up thereafter were stratified based on the occurrence of SCV within 6 h from ED admission. Propensity score matching (PSM) was employed to adjust for relevant baseline differences. The primary outcome was a composite of progression to permanent AF, progression to persistent AF, initiation of antiarrhythmic drugs, AF ablation and need for pharmacologic or electrical cardioversion. Secondary outcomes included AF episodes frequency and individual components of the composite outcome.
resultsOut of 158 patients, 52 experienced SCV while 106 required active cardioversion. After PSM, 52 matched pairs were analyzed. During a median follow-up of 17.0 months (IQR: 12.8-21.3 months), the primary composite outcome occurred significantly less frequently in the SCV group compared to the non-SCV group (21 vs. 41 events; log-rank p < 0.001). SCV was associated with a significant reduction of primary outcome occurrence (OR 0.361 [95% CI: 0.176; 0.739], p-value 0.005). The SCV group also exhibited a lower arrhythmic burden, with fewer AF episodes (median 1 [3] vs. 2 [4], p < 0.001) and reduced need for cardioversion (p = 0.008). The primary and secondary outcomes did not differ among SCV and non-SCV groups in the unmatched population.
conclusionsSCV in patients with PAF is associated with lower arrhythmic burden and reduced need for rhythm-control strategies at follow-up.
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