Budeus M, Hennersdorf M, Perings C, Strauer B E
Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Klinik und Poliklinik B der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Z Kardiol. 2004 Apr;93(4):295-9. doi: 10.1007/s00392-004-0052-x.
Patients with paroxysmal atrial fibrillation have a lower chemoreflex sensitivity (CHRS) which is characterized as an autonomic dysfunction. Because of this observation we examined the theory of an autonomic dysfunction as the reason for the reccurrence of atrial fibrilation after electrical cardioversion.
We measured the CHRS among 43 patients 24 h after successful electrical cardioversion and the patients were controlled for at least 6 months.
During the six months of follow-up a recurrence was observed in 18 patients with a mean of 8.3 days. There was no difference in organic heart disease or in the use of drugs. Left atrial diameter was not significantly larger in patients with a recurrence. Patients with a recurrence have a significantly lower CHRS than patients with sinus rhythm (2.41 +/- 1.82 vs 5.62 +/- 3.02 ms/mmHg, p < 0.04). The diagnostic value of a CHRS below 3.0 ms/mmHg achieved a specificity of 68%, a sensitivity of 67%, a positive and negative predictive value of 60% and 74%.
An analysis of CHRS seems to be an appropriate method to predict a recurrence of atrial fibrillation. The predictive power of the method has to be examined by prospective investigations of a larger patient population and a longer follow-up. Patients with paroxysmal atrial fibrillation have a lower chemoreflex sensitivity (CHRS) which is characterized as an autonomic dysfunction. Because of this observation we examined the theory of an autonomic dysfunction as the reason for the recurrence of atrial fibrillation after electrical cardioversion.
