Predictors of sinus rhythm after electrical cardioversion of atrial fibrillation: Results from a data mining project on the Flec-SL trial data set

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Emre Oto - , Bilkent University (Author)
  • Sercan Okutucu - , Ankara Numune Education and Research Hospital (Author)
  • Deniz Katircioglu-Öztürk - , Bilkent University (Author)
  • Halil Altay Güvenir - , Bilkent University (Author)
  • Ergun Karaagaoglu - , Hacettepe University (Author)
  • Martin Borggrefe - , University of Mannheim (Author)
  • Günter Breithardt - , Atrial Fibrillation NETwork, University of Münster (Author)
  • Andreas Goette - , Atrial Fibrillation NETwork, St. Vincenz Hospital GmbH (Author)
  • Ursula Ravens - , Institute of Pharmacology and Toxicology (Author)
  • Gerhard Steinbeck - , Ludwig Maximilian University of Munich (Author)
  • Karl Wegscheider - , University of Hamburg (Author)
  • Ali Oto - , Ankara Numune Education and Research Hospital (Author)
  • Paulus Kirchhof - , Atrial Fibrillation NETwork, University of Birmingham, University of Münster (Author)

Abstract

Aims Data mining is the computational process to obtain information from a data set and transform it for further use. Herein, through data mining with supportive statistical analyses, we identified and consolidated variables of the Flecainide Short-Long (Flec-SL - AFNET 3) trial dataset that are associated with the primary outcome of the trial, recurrence of persistent atrial fibrillation (AF) or death. Methods and results The Ranking Instances by Maximizing the Area under the ROC Curve' (RIMARC) algorithm was applied to build a classifier that can predict the primary outcome by using variables in the Flec-SL dataset. The primary outcome was time to persistent AF or death. The RIMARC algorithm calculated the predictive weights of each variable in the Flec-SL dataset for the primary outcome. Among the initial 21 parameters, 6 variables were identified by the RIMARC algorithm. In univariate Cox regression analysis of these variables, increased heart rate during AF and successful pharmacological conversion (PC) to sinus rhythm (SR) were found to be significant predictors. Multivariate Cox regression analysis revealed successful PC as the single relevant predictor of SR maintenance. The primary outcome risk was 3.14 times (95% CI:1.7-5.81) lower in those who had successful PC to SR than those who needed electrical cardioversion. Conclusions Pharmacological conversion of persistent AF with flecainide without the need for electrical cardioversion is a powerful and independent predictor of maintenance of SR. A strategy of flecainide pretreatment for 48 h prior to planned electrical cardioversion may be a useful planning of a strategy of long-term rhythm control.

Details

Original languageEnglish
Pages (from-to)921-928
Number of pages8
JournalEuropace
Volume19
Issue number6
Publication statusPublished - 1 Jun 2017
Peer-reviewedYes

External IDs

PubMed 27377074

Keywords

Keywords

  • Atrial fibrillation, Cardioversion, Data mining, Flecainide, RIMARC algorithm