{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:59:54Z","timestamp":1791910794521,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,7,3]],"date-time":"2012-07-03T00:00:00Z","timestamp":1341273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p><jats:italic>\n            <jats:bold>Background:<\/jats:bold> Current definition of persistent atrial fibrillation (PAF) enrolls a heterogeneous population with different atrial fibrillation (AF) exposure and degree of atrial substrate. Study aims were to evaluate acute and long\u2010term results of electrical cardioversion (ECV) and to identify temporal cutoff of previous AF exposure to reclassify PAF in subgroups with different chance of sinus rhythm (SR) maintenance.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Methods:<\/jats:bold> Five hundred twenty\u2010one patients (66% men; age 69 \u00b1 10 years) with PAF undergoing ECV, were divided in four groups according to AF duration at the time of ECV: group A with AF \u22642 months (141 patients); group B with AF &gt;2 and \u22644 months (176 patients); group C with AF &gt;4 and \u22646 months (89 patients); and group D with AF &gt;6 months and &lt;1 year (115 patients).<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Results:<\/jats:bold> There was no difference in term of acute success among groups (98.5% vs 97.1% vs 98.9% vs 96.5%, respectively, P = 0.95). At 5\u2010year follow\u2010up, 198 (41%) patients were in SR: 50% in group A, 44% in group B, 42% in group C, and 25% in group D (P &lt; 0.001). At the multivariate analysis, previous ECV (hazard ratio [HR] 1.55, P &lt; 0.001), left atrium enlargement (HR 1.39, P = 0.013), and AF duration &gt;6 months at time of procedure (HR 1.59, P = 0.001) independently predict ECV failure.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Conclusion:<\/jats:bold> ECV is associated with high acute success rate and low complications rate. Long\u2010term results are strongly related with AF duration at time of ECV: a cutoff of &gt;6 months helps in selecting patients that can take greater advantage of the procedure. 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