: Background: The probability of spontaneous conversion (SCV) to sinus rhythm (SR) in patients presenting to the emergency department (ED) with hemodynamically stable, symptomatic atrial fibrillation (AF) is not well known. Objective: To develop and validate a score to determine the probability of SCV to SR in patients presenting to the ED with hemodynamically stable, symptomatic AF. Methods: This retrospective, observational study enrolled consecutive patients admitted with AF to the ED. Variables associated to SCV during a 6 h "wait-and-see" approach were used to develop and validate a score to determine the probability of SCV to SR in AF patients. The study was divided in two phases: (1) score development and (2) validation of the predictive score. Results: Out of 748 eligible patients, 446 patients were included in the derivation cohort, whereas 302 patients were included in the validation cohort. In the derivation cohort, based on multivariable logistic analysis, a probability score weight was developed including: previous SCV (3 points), AF-related symptom duration < 24 h (5 points), age ≥ 65 years (3 points) and female sex (2 points). The score allowed us to divide patients in three groups based on the probability of SCV to SR during the 6 h observation period. The probability prediction model showed an area under the curve (AUC) of 0.707 and 0.701 in the derivation and validation cohorts, respectively. Conclusions: The proposed score allowed us to predict SCV probability with good accuracy and may help physicians in tailoring AF management in an effective and timely manner.

Probability score to predict spontaneous conversion to sinus rhythm in patients with symptomatic atrial fibrillation when less could be more / Mariani, Marco Valerio; Pierucci, Nicola; Trivigno, Sara; Cipollone, Pietro; Piro, Agostino; Chimenti, Cristina; Della Rocca, Domenico Giovanni; Miraldi, Fabio; Vizza, Carmine Dario; Lavalle, Carlo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:5(2024). [10.3390/jcm13051470]

Probability score to predict spontaneous conversion to sinus rhythm in patients with symptomatic atrial fibrillation when less could be more

Mariani, Marco Valerio
;
Pierucci, Nicola;Trivigno, Sara;Cipollone, Pietro;Piro, Agostino;Chimenti, Cristina;Miraldi, Fabio;Vizza, Carmine Dario;Lavalle, Carlo
2024

Abstract

: Background: The probability of spontaneous conversion (SCV) to sinus rhythm (SR) in patients presenting to the emergency department (ED) with hemodynamically stable, symptomatic atrial fibrillation (AF) is not well known. Objective: To develop and validate a score to determine the probability of SCV to SR in patients presenting to the ED with hemodynamically stable, symptomatic AF. Methods: This retrospective, observational study enrolled consecutive patients admitted with AF to the ED. Variables associated to SCV during a 6 h "wait-and-see" approach were used to develop and validate a score to determine the probability of SCV to SR in AF patients. The study was divided in two phases: (1) score development and (2) validation of the predictive score. Results: Out of 748 eligible patients, 446 patients were included in the derivation cohort, whereas 302 patients were included in the validation cohort. In the derivation cohort, based on multivariable logistic analysis, a probability score weight was developed including: previous SCV (3 points), AF-related symptom duration < 24 h (5 points), age ≥ 65 years (3 points) and female sex (2 points). The score allowed us to divide patients in three groups based on the probability of SCV to SR during the 6 h observation period. The probability prediction model showed an area under the curve (AUC) of 0.707 and 0.701 in the derivation and validation cohorts, respectively. Conclusions: The proposed score allowed us to predict SCV probability with good accuracy and may help physicians in tailoring AF management in an effective and timely manner.
2024
atrial fibrillation; emergency department; spontaneous conversion
01 Pubblicazione su rivista::01a Articolo in rivista
Probability score to predict spontaneous conversion to sinus rhythm in patients with symptomatic atrial fibrillation when less could be more / Mariani, Marco Valerio; Pierucci, Nicola; Trivigno, Sara; Cipollone, Pietro; Piro, Agostino; Chimenti, Cristina; Della Rocca, Domenico Giovanni; Miraldi, Fabio; Vizza, Carmine Dario; Lavalle, Carlo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:5(2024). [10.3390/jcm13051470]
File allegati a questo prodotto
File Dimensione Formato  
Mariani_Probability_2024.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 558.4 kB
Formato Adobe PDF
558.4 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1727525
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 12
social impact