Increase in regional cerebral saturation after elective electrical cardioversion of atrial fibrillation is only transient and without beneficial effects on neuropsychological functioning: cerebral saturation during electrical cardioversion

Abstract

We aimed to confirm the positive association between a successful electrical cardioversion (ECV) and increase in SctO(2)and investigated whether this increase is persisting or not. Secondary, the influence of a successful ECV on the neuropsychological function and the association with SctO(2)was assessed as well. SctO(2)was measured continuously during elective ECV using near-infrared spectroscopy. Measurements started before induction of sedation and ended 15 min after awakening. A second measurement took place 4 to 6 weeks after ECV. To assess neuropsychological functioning, patients performed standardized neuropsychological tests before ECV and at follow-up and were compared to healthy volunteers as control group. SctO(2)was measured in 60 patients during elective ECV. ECV was successful in 50 AF patients, while in ten patients sinus rhythm was not obtained. SctO(2)increased immediately after successful ECV in 50 patients (1% (- 5 to 4); p = 0.031), but not after unsuccessful ECV in 10 patients (- 1% (- 5;3); p = 0.481). This SctO(2)change was positively correlated with the instant change in blood pressure (R-2 = 0.391; p = 0.004). At follow-up, SctO(2)values were no longer increased. Nevertheless, successful ECV improved the patient's quality of life but did not influence neuropsychological functioning at follow-up. A transient, instant SctO(2)increase was observed after successful ECV. This temporary increase in SctO(2)did not influence the neuropsychological functioning of the patients. Though, the quality of life of patients with a successful ECV improved.