Association between Doppler Flow of Atrial Fibrillatory Contraction and Recurrence of Atrial Fibrillation after Electrical Cardioversion

Kim, Hyungseop; Lee, Jaepil; Yoon, Hyuck–Jun; Park, Hyoung‐Seob; Nam, Chang‐Wook; Hur, Seung‐Ho; Kim, Yoon-Nyun; Kim, Kwon-Bae

doi:10.1016/j.echo.2014.05.013

Cited by 8 publications

(10 citation statements)

References 23 publications

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“…Kim et al reported that the presence of left atrial fibrillatory contraction flow, measured immediately after early diastolic mitral inflow during AF, predicted long-term success of electrical cardioversion. [12] In a study among 3251 patients with first-time successful transoesophagealguided cardioversion, LAAEV was independently associated with maintenance of sinus rhythm, ischaemic stroke, and mortality over 12 years. [13] Luong et al, who assessed mechanical atrial remodelling during sinus rhythm, showed that right and left atrial emptying fraction after successful electrical cardioversion were better predictors of sinus rhythm maintenance than were right and left atrial volume indices.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] To assess the mechanical function of the left atrium (LA) or left atrial appendage (LAA) by echocardiography, we can use the assessment of the left atrial emptying fraction (LA EF), measurement of blood flow velocity through the mitral valve, strain or strian rate using tissue doppler technique imagine (TDI) or speckle tracking echocardiography (STE) and measurements of left atrial appendage emptying velocity (LAAEV). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Currently, much attention is paid to the use of STE technique to assess the mechanical function of LA and LAA, however, due to the limitations of this method, i.e. obtaining optimal visualization, especially in the middle and distal segments of LAA, we decided to use the TDI technique.…”

Section: Introductionmentioning

confidence: 99%

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Left atrial mechanical remodelling assessed as the velocity of left atrium appendage wall motion during atrial fibrillation is associated with maintenance of sinus rhythm after electrical cardioversion in patients with persistent atrial fibrillation

et al. 2020

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The velocity of left atrium appendage (LAA) wall motion during atrial fibrillation (AF) is a potential marker of mechanical remodelling. In this study, we investigated whether the velocity of LAA wall motion during AF predicted the success of electrical cardioversion and long-term sinus rhythm maintenance. Standard echocardiographic data were obtained by transthoracic echocardiography, and LAA wall motion velocities were measured by transoesophageal echocardiography. With logistic regression and receiver operating characteristic curve analyses, we related echocardiographic and clinical data to cardioversion outcomes and sinus rhythm maintenance at 12 months. Of 121 patients prospectively included in the study, electrical cardioversion restored sinus rhythm in 97 (81.2%), and 51 (42%) patients maintained sinus rhythm at 12 months. Patients in whom cardioversion restored sinus rhythm had higher LAA wall motion velocities than did the patients with failed cardioversions (p <0.001). Compared to patients with AF at 12 months, patients who maintained sinus rhythm had lower maximum and end-diastolic left atrial volumes (p � 0.01), lower E/e' ratios (p = 0.005), higher s' values (p = 0.013), and higher LAA motion velocities (p < 0.001). On multivariate logistic regression, only LAA wall motion velocity and E/e' ratios remained significant predictors of sinus rhythm maintenance at 12 months (p � 0.04). LAA wall motion velocity was also a significant predictor of sinus rhythm maintenance when corrected for clinical variables (p = 0.039). Conclusion: LAA wall motion velocity, as a marker of mechanical remodelling, can predict short-term and long-term sinus rhythm maintenance after electrical cardioversion in AF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Left atrial mechanical remodelling assessed as the velocity of left atrium appendage wall motion during atrial fibrillation is associated with maintenance of sinus rhythm after electrical cardioversion in patients with persistent atrial fibrillation

et al. 2020

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“…In line with previous reports, overall AF recurrence rate in our study population was 60.6% (40/66). 7 8 Diastolic dysfunction is linked with poorer cardiovascular outcomes, development of AF, more severe AF symptoms, as well known. 9 The main finding of this study was that elevated LV filling pressure, as indicated by the increased E/e' ratio, was correlated significantly with AF recurrence after cardioversion.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Filling Pressure as Assessed by the E/e' Ratio Is a Determinant of Atrial Fibrillation Recurrence after Cardioversion

et al. 2016

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PurposeLeft ventricular (LV) filling pressure affects atrial fibrillation (AF) recurrence. We investigated the relationship between diastolic dysfunction and AF recurrence after cardioversion, and whether LV filling pressure was predictive of AF recurrence.Materials and MethodsSixty-six patients (mean 58±12 years) with newly diagnosed persistent AF were retrospectively enrolled. We excluded patients with left atrial (LA) diameters larger than 50 mm, thereby isolating the effect of LV filling pressure. We evaluated the differences between the patients with (group 1) and without AF recurrence (group 2).ResultsGroup 1 showed increased LA volume index (LAVI) and E/e' compared to group 2 (p<0.05). During a mean follow-up period of 25±19 months, AF recurrence after cardioversion was 60.6% (40/66). The area under the receiver operating characteristics curve of E/e' for AF recurrence was 0.780 [95% confidence interval (CI): 0.657-0.903], and the optimal cut-off value of the E/e' was 9.15 with 75.0% of sensitivity and 73.1% of specificity. A Kaplan-Meier survival curve showed that the cumulative recurrence-free survival rate was significantly lower in patients with higher LV filling pressure (E/e'>9.15) compared with patients with lower LV filling pressure (E/e'≤9.15) (log rank p=0.008). Cox regression analysis revealed that E/e' [hazards ratio (HR): 1.100, 95% CI: 1.017-1.190] and LAVI (HR: 1.042, 95% CI: 1.002-1.084) were independent predictors for AF recurrence after cardioversion.ConclusionLV filling pressure predicts the risk of AF recurrence in persistent AF patients after cardioversion.

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“…Managing AF patients who underwent successful cardioversion can be challenging due to the possibility of AF recurrence, with rates as high as 70%. 16,17 Factors associated with an increased risk for AF recurrence after elective cardioversion include older age, female sex, previous cardioversion, chronic obstructive pulmonary disease, renal impairment, structural heart disease, and increased LA volume index. 18 To properly manage these patients, prognostic determination may be essential to identify patients with high-risk AF recurrence.…”

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confidence: 99%

A Prognostic Score To Predict Atrial fibrillation Recurrence After External Electrical Cardioversion—SLAC Score

Thangjui

Yodsuwan

Thyagaturu

et al. 2022

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Introduction: Atrial fibrillation (AF) recurrence after a successful external electrical cardioversion (ECV) is common. Assessing an individual's risk of AF recurrence is a critical part of the treatment plan. We aimed to develop a prognostic prediction score to predict AF recurrence in AF patients who underwent successful ECV. Methods: A retrospective cohort study that included AF patients who underwent successful ECV was conducted with a primary outcome of AF recurrence at 6 months. Logistic regression analysis was done to identify variables, and a prognostic prediction score was created and internally validated. Results: Four prognostic predictors were identified, including the type of AF, persistent AF (1 point) and long-standing persistent AF (4 points), previous cardioversion (1 point), stroke/transient ischemic attack (3 points), and left atrial volume index ≥40 mL/m 2 (6 points). The total score of 14 was further divided into 3 risk groups; low-risk (0-2 points), moderate-risk (3-7 points), and high-risk (8-14 points). The positive likelihood ratio for a moderate-risk patient was 2.08 (95% CI, 1.64-2.63) and for a high-risk patient was 7.90 (95% CI, 2.48-25.17). The score showed good discrimination power with the c-statistic of 0.74 (95% CI, 0.69-0.79). Conclusions: A simple prognostic prediction score for AF recurrence after successful ECV was created with a promising internally validated discrimination power. An external assessment of its usefulness as a tool to identify patients with low, moderate, and high risk for AF recurrence is warranted.

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Association between Doppler Flow of Atrial Fibrillatory Contraction and Recurrence of Atrial Fibrillation after Electrical Cardioversion

Cited by 8 publications

References 23 publications

Left atrial mechanical remodelling assessed as the velocity of left atrium appendage wall motion during atrial fibrillation is associated with maintenance of sinus rhythm after electrical cardioversion in patients with persistent atrial fibrillation

Left atrial mechanical remodelling assessed as the velocity of left atrium appendage wall motion during atrial fibrillation is associated with maintenance of sinus rhythm after electrical cardioversion in patients with persistent atrial fibrillation

Left Ventricular Filling Pressure as Assessed by the E/e' Ratio Is a Determinant of Atrial Fibrillation Recurrence after Cardioversion

A Prognostic Score To Predict Atrial fibrillation Recurrence After External Electrical Cardioversion—SLAC Score

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