Short-term success and recurrence of supraventricular arrhythmias after electrical cardioversion

Objectives: Electrical cardioversion is a common treatment for terminating supraventricular arrhythmias, particularly atrial fibrillation. However, factors related to immediate success and subsequent arrhythmia recurrence remain unclear in some populations. This study assessed the immediate success rate of electrical cardioversion and the recurrence rate among patients who initially responded. Methods: This analytical cross-sectional study was conducted at Afshar Hospital in Yazd, Iran, from 2014 to 2019. A consecutive sample of 75 adults with supraventricular arrhythmias (atrial fibrillation, atrial flutter, or atrial tachycardia) who underwent electrical cardioversion was included. Patients with prior CABG, pregnancy, or incomplete records were excluded. Data were collected using a structured checklist covering demographics, clinical history (cardiac disease, valvular disease, diabetes, hypertension, smoking), and procedural outcomes (immediate success, number of attempts, recurrence). Analyses were performed in SPSS v 26. Results: Among 75 patients (60% male; mean age 52 ± 15 years), atrial fibrillation was the most common arrhythmia (44%). Electrical cardioversion restored sinus rhythm immediately in 68 patients (90%). Immediate success was not significantly associated with baseline comorbidities (cardiac disease, valvular disease, diabetes, hypertension, or smoking), left ventricular ejection fraction, or arrhythmia subtype (all p > 0.05). During follow-up, recurrence occurred in 23 of 68 patients with immediate success (33.8%) and was not significantly related to comorbidities, LVEF, or arrhythmia type (all p > 0.05). However, recurrence differed significantly by immediate procedural outcome (p = 0.001). Conclusions: Electrical cardioversion achieved a high immediate success rate in supraventricular arrhythmias, and successful cardioversion was associated with a substantially lower recurrence rate. Comorbid conditions did not significantly influence immediate procedural success in this cohort.