Main Article Content
Abstract
RÉSUMÉ
Introduction. La fibrillation atriale (FA) est le trouble du rythme cardiaque soutenu le plus fréquent, en particulier chez les sujets âgés ou porteurs de cardiopathie. D’après les données de la littérature sa prise en charge est variable selon le contexte clinique avec une faible attention accordée au contrôle du rythme cardiaque. Le but de ce travail était d’étudier l’évolution à un an du rythme cardiaque après cardioversion électrique pour FA à Yaoundé. Méthodologie. pendant une période de 17 mois nous avons mené une étude longitudinale et descriptive dans les services de cardiologie à l’Hôpital Central et de l’Hôpital Général de Yaoundé. Les variables étudiées étaient les aspects sociodémographiques, cliniques et les facteurs associés à la récidive de la FA après cardioversion électrique. Résultats. Nous avons recruté 43 patients ayant un âge moyen de 61,79+/-8,31 ans. Le sexe masculin était majoritaire (sex-ratio H/F = 1,52). Les comorbidités des patients étaient dominées par l’hypertension artérielle (65,1%), les valvulopathies (48,8%) et l’insuffisance cardiaque (42,2%). Les types de FA les plus fréquemment retrouvés étaient la FA permanente (76,7%) et la FA persistance prolongée (14%). La récidive de FA après cardioversion, à un mois et à un an était respectivement de 26,3% et 88,2%. Le seul facteur associé à la récidive de la FA était la dilatation de l’oreillette gauche avec la surface et le diamètre antéropostérieur respectivement supérieurs à 30 cm2 et 50 mm. Conclusion. Le taux de récidive de FA après cardioversion est important dans notre milieu. La dilatation importante de l’oreillette gauche est le seul facteur de risque indépendant retrouvé.
ABSTRACT
Introduction. Atrial fibrillation (AF) is the most sustained and frequent cardiac rhythm disorder, particularly in elderly subjects or in those with heart disease. According to the literature, its management varies depending on the clinical context with a less attention given to rythme control. Our goal was to investigate the one-year outcome of heart rhythm after electrical cardioversion in Yaoundé. Methodology. During a period of 17 monts, we conducted a longitudinal and descriptive study during at the cardiology units of the Central and General Hospitals in Yaounde. Our data of intrest were sociodemographic and clinical presentation; and risk factors of recurrence of AF after electrical cardioversion. Results. We enrolled 43 patients with a mean age of 61.79 +/- 8.31 years. Males prevailed with a sex ratio of 1.52. The patient’s comorbidities were dominated by hypertension (65.1%), valve disease (48.8%) and heart failure (42.2%). The most common types of AF were permanent AF (76.7%) and long standing persistent AF (14%). AF recurrence after cardioversion at one month and one year was 26.3% and 88.2%, respectively. Left atrial enlargement with area and anteroposterior diameter greater than 30 cm2 and 50mm respectively was the only risk factor for AF recurrence. Conclusion. AF recurrence rate after cardioversion is high in our setting. Significant left atrial enlargement is a risk factor of AF recurrence after cardioversion.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Authors/Task Force Members, Camm AJ, Lip GYH, De Caterina R, Savelieva I, Atar D, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J.2012;33(21):2719‑47.
- Alonso A, Bengtson LGS. A Rising Tide: The Global Epidemic of Atrial Fibrillation. Circulation.2014;129(8):829‑30.
- Nguyen TN, Hilmer SN, Cumming RG. Review of epidemiology and management of atrial fibrillation in developing countries. Int J Cardiol.2013;167(6):2412‑20.
- Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic Features of Chronic Atrial Fibrillation: The Framingham Study. N Engl J Med.1982;306(17):1018‑22.
- Cameron A, Schwartz MJ, Kronmal RA, Kosinski AS. Prevalence and significance of atrial fibrillation in coronary artery disease (CASS registry). Am J Cardiol.1988;61(10):714‑7.
- Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J.2021;42(5):373‑498.
- Paziaud O, Piot O, Rousseau J, Copie X, Lavergne T, Guize L, et al. Cardioversion électrique externe des troubles du rythme atriaux : critères prédictifs de succès. Ann Cardiol Angéiologie.2003;52(4):232‑8.
- Douya Kouadjio G. Evolution du rythme cardiaque après cardioversion pour fibrillation auriculaire à Yaoundé : à propos de 19 patients Directeur. [Cmeroun, Yaoundé]: Faculté de Medecine et des Sciences Biomédicales de Yaound; 2015.
- Vest, J, et al. Ablation de la fibrillation auriculaire par radiofréquence. La santé est une ressource de la vie quotidienne. 2012;39(4):17.
- Lehto M, Kala R. Persistent atrial fibrillation: a population based study of patients with their first cardioversion. Int J Cardiol.2003;92(2‑3):145‑50.
- Lin J-M, Lin J-L, Lai L-P, Tseng Y-Z, Stephen Huang SK. Predictors of Clinical Recurrence after Successful Electrical Cardioversion of Chronic Persistent Atrial Fibrillation: Clinical and Electrophysiological Observations. Cardiology. 2002;97(3):133‑7.
- Kuppahally SS, Foster E, Shoor S, Steimle AE. Short-term and long-term success of electrical cardioversion in atrial fibrillation in managed care system. Int Arch Med. 2009;2(1):39.
- Palinkas A. Clinical value of left atrial appendage flow velocity for predicting of cardioversion success in patients with non-valvular atrial fibrillation*1. Eur Heart J. 2001;22(23):2201‑8.
- Arnar DO, Danielsen R. Factors Predicting Maintenance of Sinus Rhythm after Direct Current Cardioversion of Atrial Fibrillation and Flutter: A Reanalysis with Recently Acquired Data. Cardiology. 1996;87(3):181‑8.
- Morris J, Peter R, McIntosh H. Electrical cardioversion of atrial fibrillation: immediate and long term results and selection of patients. Ann Intern Med. 1966;65:216-31.
- Tieleman RG, Van Gelder IC, Crijns HJGM, De Kam PJ, Van Den Berg MP, Haaksma J, et al. Early Recurrences of Atrial Fibrillation After Electrical Cardioversion: A Result of Fibrillation-Induced Electrical Remodeling of the Atria? J Am Coll Cardiol. 1998;31(1):167‑73.
- Brodsky MA, Allen BJ, Capparelli EV, Luckett CR, Morton R, Henry WL. Factors determining maintenance of sinus rhythm after chronic atrial fibrillation with left atrial dilatation. Am J Cardiol.1989;63(15):1065‑8.
- Brodsky MA, Allen BJ, Walker CJ, Casey TP, Luckett CR, Henry WL. Amiodarone for maintenance of sinus rhythm after conversion of atrial fibrillation in the setting of a dilated left atrium. Am J Cardiol.1987;60(7):572‑5.
- Bertaglia E. Success of serial external electrical cardioversion of persistent atrial fibrillation in maintaining sinus rhythm. A randomized study. Eur Heart J.2002;23(19):1522‑8.
References
Authors/Task Force Members, Camm AJ, Lip GYH, De Caterina R, Savelieva I, Atar D, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J.2012;33(21):2719‑47.
Alonso A, Bengtson LGS. A Rising Tide: The Global Epidemic of Atrial Fibrillation. Circulation.2014;129(8):829‑30.
Nguyen TN, Hilmer SN, Cumming RG. Review of epidemiology and management of atrial fibrillation in developing countries. Int J Cardiol.2013;167(6):2412‑20.
Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic Features of Chronic Atrial Fibrillation: The Framingham Study. N Engl J Med.1982;306(17):1018‑22.
Cameron A, Schwartz MJ, Kronmal RA, Kosinski AS. Prevalence and significance of atrial fibrillation in coronary artery disease (CASS registry). Am J Cardiol.1988;61(10):714‑7.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J.2021;42(5):373‑498.
Paziaud O, Piot O, Rousseau J, Copie X, Lavergne T, Guize L, et al. Cardioversion électrique externe des troubles du rythme atriaux : critères prédictifs de succès. Ann Cardiol Angéiologie.2003;52(4):232‑8.
Douya Kouadjio G. Evolution du rythme cardiaque après cardioversion pour fibrillation auriculaire à Yaoundé : à propos de 19 patients Directeur. [Cmeroun, Yaoundé]: Faculté de Medecine et des Sciences Biomédicales de Yaound; 2015.
Vest, J, et al. Ablation de la fibrillation auriculaire par radiofréquence. La santé est une ressource de la vie quotidienne. 2012;39(4):17.
Lehto M, Kala R. Persistent atrial fibrillation: a population based study of patients with their first cardioversion. Int J Cardiol.2003;92(2‑3):145‑50.
Lin J-M, Lin J-L, Lai L-P, Tseng Y-Z, Stephen Huang SK. Predictors of Clinical Recurrence after Successful Electrical Cardioversion of Chronic Persistent Atrial Fibrillation: Clinical and Electrophysiological Observations. Cardiology. 2002;97(3):133‑7.
Kuppahally SS, Foster E, Shoor S, Steimle AE. Short-term and long-term success of electrical cardioversion in atrial fibrillation in managed care system. Int Arch Med. 2009;2(1):39.
Palinkas A. Clinical value of left atrial appendage flow velocity for predicting of cardioversion success in patients with non-valvular atrial fibrillation*1. Eur Heart J. 2001;22(23):2201‑8.
Arnar DO, Danielsen R. Factors Predicting Maintenance of Sinus Rhythm after Direct Current Cardioversion of Atrial Fibrillation and Flutter: A Reanalysis with Recently Acquired Data. Cardiology. 1996;87(3):181‑8.
Morris J, Peter R, McIntosh H. Electrical cardioversion of atrial fibrillation: immediate and long term results and selection of patients. Ann Intern Med. 1966;65:216-31.
Tieleman RG, Van Gelder IC, Crijns HJGM, De Kam PJ, Van Den Berg MP, Haaksma J, et al. Early Recurrences of Atrial Fibrillation After Electrical Cardioversion: A Result of Fibrillation-Induced Electrical Remodeling of the Atria? J Am Coll Cardiol. 1998;31(1):167‑73.
Brodsky MA, Allen BJ, Capparelli EV, Luckett CR, Morton R, Henry WL. Factors determining maintenance of sinus rhythm after chronic atrial fibrillation with left atrial dilatation. Am J Cardiol.1989;63(15):1065‑8.
Brodsky MA, Allen BJ, Walker CJ, Casey TP, Luckett CR, Henry WL. Amiodarone for maintenance of sinus rhythm after conversion of atrial fibrillation in the setting of a dilated left atrium. Am J Cardiol.1987;60(7):572‑5.
Bertaglia E. Success of serial external electrical cardioversion of persistent atrial fibrillation in maintaining sinus rhythm. A randomized study. Eur Heart J.2002;23(19):1522‑8.