Impact of the Optimal Patient Education and Medical Therapy after Cardioversion of AF: A Middle-Term Follow-Up Study

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Background: Previous studies show that many factors are significantly associated with development and maintenance of atrial fibrillation (AF), however, little is known about the prognosis of the patients who received individually-optimized education to prevent AF recurrence after cardioversion. Method: We chose 37 cases prepared for cardioversion in 142 consecutive patients receiving trans-esophageal echocardiography (TEE) from December 2008 to June 2010. Indication of cardioversion was (1) patient requiring cardioversion because of symptomatic and/or drug refractory AF and (2) patient who wish to restore the heart rhythm to sinus rhythm (SR) by cardioversion. 11 patients (29.7%) were excluded from this study because of intracardiac thrombi. 26 patients were divided into 4 groups by duration of AF: Group 1; within 1 week (2 patients), Group 2; <1 month (3 patients), Group 3; <1 year (12 patients) and Group 4; more than 1 year (8 patients), respectively. Result: All patients were successfully restored to SR. After cardioversion, medical therapy and patient education were performed. After follow-up period (mean±SD; 249±146 days), 15 patients (62.5%) maintained SR, especially 9 patients (75%) in Group 3 maintained SR. Conclusion: Cardioversion of persistent AF with medical therapy and optimal patient education may be equally-effective strategy compare with catheter ablation of persistent AF.