open access

Vol 20, No 6 (2013)
Original articles
Published online: 2013-12-11
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Predictive value of atrial electromechanical delay for atrial fibrillation recurrence

Hasan Ari, Selma Ari, Mehmet Akkaya, Cihan Aydin, Nadir Emlek, O. Yaşar Sarigül, Seçkin Çetinkaya, Tahsin Bozat, Muhammet Şentürk, Kemal Karaağaç, Mehmet Melek, Mustafa Yilmaz
DOI: 10.5603/CJ.2013.0164
·
Cardiol J 2013;20(6):639-647.

open access

Vol 20, No 6 (2013)
Original articles
Published online: 2013-12-11

Abstract

Background: We investigated the predictive value of atrial electromechanical delay (AEMD) for recurrence of atrial fibrillation (AF) at 1-month after cardioversion.

Methods: Seventy-seven patients with persistent AF were evaluated and finally 50 patients (12 men, 38 women) were included. All patients underwent transthoracic electrical DC cardioversion under amiodarone treatment. AEMD was measured as the time interval from the onset of the P wave on electrogram (ECG) to the beginning of late diastolic wave (Am) from the ventricular annulus and atrial walls on tissue Doppler imaging, in the apical 4-chamber view 24 h after cardiversion. P wave maximum-duration (Pmax), P wave minimum-duration (Pmin) and P wave dispersion-duration (Pdis) were calculated on the 12-lead ECG at 24-h postcardioversion. We followed the heart rate and rhythm by 12-lead ECG at 24-h, 1-week and 1-month.

Results: At 1-month follow-up after cardioversion, 28 (56%) patients were in sinus rhythm (SR), whereas 22 (44%) patients reverted to AF. The AEMD durations were longer in AF group than SR group (p < 0.001) and were signifi cantly correlated with Pmax and Pdis (p < 0.001 for both). For AF recurrence; duration of AF, left atrial (LA) diameter, maximum LA volume index, mitral A velocity and LA lateral AEMD were significant parameters in univariate-analysis, however LA lateral AEMD was the only significant parameter in multivariate-analysis (OR: 1.46; 95% CI 1.02–2.11; p = 0.03).

Conclusions: Our results suggest that AEMD is associated with an increased risk of recurrence of AF within 1-month. These data may have implications for the identification of patients who are most likely to experience substantial benefit from cardiversion therapy for AF.

Abstract

Background: We investigated the predictive value of atrial electromechanical delay (AEMD) for recurrence of atrial fibrillation (AF) at 1-month after cardioversion.

Methods: Seventy-seven patients with persistent AF were evaluated and finally 50 patients (12 men, 38 women) were included. All patients underwent transthoracic electrical DC cardioversion under amiodarone treatment. AEMD was measured as the time interval from the onset of the P wave on electrogram (ECG) to the beginning of late diastolic wave (Am) from the ventricular annulus and atrial walls on tissue Doppler imaging, in the apical 4-chamber view 24 h after cardiversion. P wave maximum-duration (Pmax), P wave minimum-duration (Pmin) and P wave dispersion-duration (Pdis) were calculated on the 12-lead ECG at 24-h postcardioversion. We followed the heart rate and rhythm by 12-lead ECG at 24-h, 1-week and 1-month.

Results: At 1-month follow-up after cardioversion, 28 (56%) patients were in sinus rhythm (SR), whereas 22 (44%) patients reverted to AF. The AEMD durations were longer in AF group than SR group (p < 0.001) and were signifi cantly correlated with Pmax and Pdis (p < 0.001 for both). For AF recurrence; duration of AF, left atrial (LA) diameter, maximum LA volume index, mitral A velocity and LA lateral AEMD were significant parameters in univariate-analysis, however LA lateral AEMD was the only significant parameter in multivariate-analysis (OR: 1.46; 95% CI 1.02–2.11; p = 0.03).

Conclusions: Our results suggest that AEMD is associated with an increased risk of recurrence of AF within 1-month. These data may have implications for the identification of patients who are most likely to experience substantial benefit from cardiversion therapy for AF.

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Keywords

atrial fibrillation, cardioversion, electromechanical delay

About this article
Title

Predictive value of atrial electromechanical delay for atrial fibrillation recurrence

Journal

Cardiology Journal

Issue

Vol 20, No 6 (2013)

Pages

639-647

Published online

2013-12-11

DOI

10.5603/CJ.2013.0164

Bibliographic record

Cardiol J 2013;20(6):639-647.

Keywords

atrial fibrillation
cardioversion
electromechanical delay

Authors

Hasan Ari
Selma Ari
Mehmet Akkaya
Cihan Aydin
Nadir Emlek
O. Yaşar Sarigül
Seçkin Çetinkaya
Tahsin Bozat
Muhammet Şentürk
Kemal Karaağaç
Mehmet Melek
Mustafa Yilmaz

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