{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:13:06Z","timestamp":1761005586727,"version":"build-2065373602"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pharmacological cardioversion (PCV) is one of the therapeutic options within rhythm control strategies for atrial fibrillation (AF). Data on clinical determinants influencing its effectiveness and safety in real-world settings remain limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a sub-analysis of the multicenter Cardioversion with Intravenous Antazoline in Atrial Fibrillation II (CANT II) registry. The registry retrospectively included consecutive patients with recent-onset AF undergoing urgent PCV in six Polish centers between 2019 and 2020. We analyzed 931 patients stratified according to CHA\u2082DS\u2082-VASc score: Group I (0\u20131 points; <jats:italic>n<\/jats:italic>\u2009=\u2009194), Group II (2\u20134 points; <jats:italic>n<\/jats:italic>\u2009=\u2009580), and Group III (\u22655 points; <jats:italic>n<\/jats:italic>\u2009=\u2009157). The primary endpoint was successful restoration of sinus rhythm within 12\u2005h, and the secondary endpoint was a composite of adverse events (death, syncope, bradycardia, hypotension).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 69 years, 48% were men, and the median CHA\u2082DS\u2082-VASc score was 3. Antazoline was used in 59% of patients, amiodarone in 53%, and propafenone in 19%. Sinus rhythm was restored in 69%, 70%, and 64% of patients in Groups I, II, and III, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.45). The overall adverse event rate was low (2.1%) and did not differ significantly between groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.16). Antazoline was most effective in Group I, while propafenone showed higher efficacy in Group II.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this retrospective sub-analysis of the CANT II registry, success of pharmacological cardioversion of AF is not associated with number of comorbidities as assessed by the CHA2DS2VASc score. PCV remains a feasible and generally safe option in emergency and cardiology department practice.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1648549","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T05:23:41Z","timestamp":1760937821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Usability of CHA2DS2VASC score in predicting the effectiveness and safety of pharmacological cardioversion \u2013 data from the multicenter cardioversion with intravenous ANTazoline 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