open access

Vol 27, No 3 (2020)
Original articles — Clinical cardiology
Published online: 2019-07-08
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Echocardiographic assessment of left atrial morphology and function to predict maintenance of sinus rhythm after electrical cardioversion in patients with non-valvular persistent atrial fibrillation and normal function or mild dysfunction of left ventricle

Paweł Wałek, Janusz Sielski, Katarzyna Starzyk, Iwona Gorczyca, Joanna Roskal-Wałek, Beata Wożakowska-Kapłon
DOI: 10.5603/CJ.a2019.0068
·
Pubmed: 31313277
·
Cardiol J 2020;27(3):246-253.

open access

Vol 27, No 3 (2020)
Original articles — Clinical cardiology
Published online: 2019-07-08

Abstract

Background: The aim of this study was to assess whether echocardiographic measurements of left atrial (LA) morphology and function could predict sinus rhythm maintenance after electrical cardioversion among patients with atrial fibrillation (AF) and normal function or mild dysfunction of the left ventricle (LV).

Methods: One hundred seventeen patients with persistent AF who underwent successful electrical cardioversion were prospectively enrolled. Echocardiography was performed one day subsequent to successful cardioversion. Patients were followed up clinically and electrocardiographically at 1, 6, and 12 months. At 12 months, 61 (52%) patients had maintained sinus rhythm (SR).

Results: Compared to patients who maintained SR, those with AF recurrence had larger LAs, worse LA systolic function, and increased LV filling pressure. On multivariate stepwise logistic regression, E/A ratios (odds ratio [OR] 0.550, 95% confidence interval [CI] 0.341–0.886; p = 0.014) and E/e’ ratios (OR 0.871, 95% CI 0.771–0.985; p = 0.027) were significant predictors of AF recurrence. On receiver operator characteristic curve analysis of AF recurrence at 12 months, the area under curve for both E/A and E/e’ ratios were 0.726. With an E/A cutoff of 2.2, the sensitivity for predicting AF recur­rence at 12 months was 72%, and specificity was 73%. With an E/e’ cutoff of 9.17, the sensitivity for predicting AF recurrence at 12 months was 72%, and specificity was 74%.

Conclusions: Left ventricular filling pressure assessed with E/A and E/e’ ratios predict AF recurrence after electrical cardioversions among patients with AF and normal function of LV.

Abstract

Background: The aim of this study was to assess whether echocardiographic measurements of left atrial (LA) morphology and function could predict sinus rhythm maintenance after electrical cardioversion among patients with atrial fibrillation (AF) and normal function or mild dysfunction of the left ventricle (LV).

Methods: One hundred seventeen patients with persistent AF who underwent successful electrical cardioversion were prospectively enrolled. Echocardiography was performed one day subsequent to successful cardioversion. Patients were followed up clinically and electrocardiographically at 1, 6, and 12 months. At 12 months, 61 (52%) patients had maintained sinus rhythm (SR).

Results: Compared to patients who maintained SR, those with AF recurrence had larger LAs, worse LA systolic function, and increased LV filling pressure. On multivariate stepwise logistic regression, E/A ratios (odds ratio [OR] 0.550, 95% confidence interval [CI] 0.341–0.886; p = 0.014) and E/e’ ratios (OR 0.871, 95% CI 0.771–0.985; p = 0.027) were significant predictors of AF recurrence. On receiver operator characteristic curve analysis of AF recurrence at 12 months, the area under curve for both E/A and E/e’ ratios were 0.726. With an E/A cutoff of 2.2, the sensitivity for predicting AF recur­rence at 12 months was 72%, and specificity was 73%. With an E/e’ cutoff of 9.17, the sensitivity for predicting AF recurrence at 12 months was 72%, and specificity was 74%.

Conclusions: Left ventricular filling pressure assessed with E/A and E/e’ ratios predict AF recurrence after electrical cardioversions among patients with AF and normal function of LV.

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Keywords

atrial fibrillation, direct current cardioversion, diastolic dysfunction

About this article
Title

Echocardiographic assessment of left atrial morphology and function to predict maintenance of sinus rhythm after electrical cardioversion in patients with non-valvular persistent atrial fibrillation and normal function or mild dysfunction of left ventricle

Journal

Cardiology Journal

Issue

Vol 27, No 3 (2020)

Pages

246-253

Published online

2019-07-08

DOI

10.5603/CJ.a2019.0068

Pubmed

31313277

Bibliographic record

Cardiol J 2020;27(3):246-253.

Keywords

atrial fibrillation
direct current cardioversion
diastolic dysfunction

Authors

Paweł Wałek
Janusz Sielski
Katarzyna Starzyk
Iwona Gorczyca
Joanna Roskal-Wałek
Beata Wożakowska-Kapłon

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