Perceived heart rhythm in relation to ECG findings after direct current cardioversion of XXXX .

@entity1 @entity955
OBJECTIVE: To investigate the agreement between perceived heart rhythm and the ECG-registered heart rhythm, as well as between symptoms and the ECG after direct current (DC) cardioversion of @entity955 ( @entity955 ). METHODS: Consecutive @entity1 with symptomatic @entity955 subjected to DC cardioversion were interviewed about perceived heart rhythm and symptoms one week after restoration of sinus rhythm (SR). An ECG was obtained after the interview. A chance-corrected measure of agreement was calculated by using Cohen's kappa test. RESULTS: 356 @entity1 were enrolled. One week after successful cardioversion 160 @entity1 considered their rhythm to be regular and 222 ECGs showed SR. 130 @entity1 considered their heart rhythm to be regular in agreement with ECG in SR (kappa = 0.34, 95% confidence interval (CI) 0.24 to 0.44), indicating a fair agreement. At the same time 59 @entity1 perceived @entity955 and 134 ECGs showed @entity955 . Thirty eight @entity1 perceived @entity955 , in agreement with @entity955 found on their ECG (kappa = 0.13, 95% CI 0.02 to 0.25), a poor agreement. 141 of 356 @entity1 reported improvement of symptoms in agreement with SR on their ECG (kappa = 0.26, 95% CI 0.15 to 0.36), indicating fair agreement. Perceived SR and improvement of symptoms were strongly associated (n = 129; p < 0.001). CONCLUSION: Agreement between perceived heart rhythm and ECG, as well as between improvement of symptoms and SR recorded on the ECG, is no more than poor to fair after successful cardioversion of @entity1 with persistent @entity955 . The association between perceived SR and improvement of symptoms is strong. These findings support the need for objective criteria to select @entity1 who would benefit most from rhythm control. They also support the need for further studies on quality of life of @entity1 with @entity955 , with due attention paid to @entity1 ' perception of their cardiac rhythm.
