Echocardiographic Parameters for Predicting Maintenance of Sinus Rhythm After Internal Atrial Defibrillation

Omran, Heyder; Jung, Werner; Schimpf, Rainer; MacCarter, Dean; Rabahieh, Rami; Wolpert, Christian; Illien, Stefan; Lüderitz, Berndt

doi:10.1016/s0002-9149(98)00212-4

Cited by 55 publications

(32 citation statements)

References 19 publications

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“…Recent studies have suggested that left atrial appendage velocities measured before cardioversion predict long-term maintenance of sinus rhythm, 12 although not all authors are in agreement. 13 In a relatively large, multicenter prospective…”

Section: See P 387mentioning

confidence: 99%

Assessing Atrial Mechanical Remodeling and Its Consequences

Hoit

2005

Circulation

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T he principal function of the left atrium is to modulate left ventricular (LV) filling and cardiovascular performance through reservoir, conduit, and booster pump functions; the latter is often (mistakenly) regarded synonymously with atrial function, and in contrast to the reservoir and conduit phases, has been studied extensively. Typically, the importance of atrial contraction has been estimated by measurements of cardiac output and end-diastolic volumes both with and without effective atrial systole, by relative LV filling using Doppler transmitral velocimetry (E/A ratios) or radionuclide angiography, or by atrial shortening using 2D echocardiography, angiography, and sonomicrometry. Despite considerable investigation, the magnitude and relative importance of the atrial contribution to LV filling and cardiac output remain controversial and provide motivation for a more complete evaluation of the atrial cycle. In this regard, nearly half of the LV stroke volume and its associated energy is stored in the left atrium during ventricular systole, which acts as a ventricular restoring force during the ensuing ventricular diastole. 1 This reservoir function of the left atrium is governed by atrial compliance, which is most rigorously measured by mathematically fitting atrial pressure and volume data during ventricular systole. A number of studies have shown, however, that the proportion of left atrial inflow during ventricular systole with Doppler pulmonary venous flow (ie, S/D ratios) can estimate relative reservoir function. Thus, we showed that an isolated change in left atrial compliance alters predictably reservoir function and the pattern of pulmonary venous flow. 2 Decreased atrial compliance is associated with greater phasic atrial pressures but a lower mean level of atrial pressure during ventricular filling, and as a result, a smaller end-diastolic volume and decreased venous return. 3 In contrast, increased atrial compliance increases early LV filling and atrial systolic shortening. 4

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Section: See P 387mentioning

confidence: 99%

Assessing Atrial Mechanical Remodeling and Its Consequences

Hoit

2005

Circulation

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“…Similar results by Flaker et al (6) and Ökçün et al (22) demonstrated that an enlarged LA predicted recurrence of an AF after cardioversion. However, Omran et al (23) and Lin et al (18) found no correlation between LA diameters and recurrence of AFs. In the present study, there was no statistically significant difference of baseline atrial sizes between patients with and without an AF recurrence.…”

Section: Discussionmentioning

confidence: 95%

Diagnostic accuracy of P-wave dispersion in prediction of maintenance of sinus rhythm after external cardioversion of atrial fibrillation

Başar

Gürel²,

Özcan³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: P dalga dispersiyonu (PWD) atriyal iletimdeki farklılığı gösteren elektrokardiyografik bir ölçümdür. Bu çalışmanın amacı, eksternal kardiyoversiyon sonrası sinüs ritminde olan hastalarda PWD'nin atriyal fibrilasyon (AF) rekürrenslerini öngörmedeki tanısal değerini göstermektir. Yöntemler: Bu prospektif gözlemsel çalışmaya, başarılı eksternal kardiyoversiyonla sinüs ritmi sağlanmış, kapak hastalığı dışı persistan AF'si olan 26 hasta dâhil edildi (13 erkek, yaş ortalaması 58.1±11 yıl). Eksternal kardiyoversiyondan hemen sonra, P dalga süresini ölçmek için tüm hastaların 12 derivasyonlu yüzeysel elektrokardiyografileri çekildi. Sinüs ritmi sağlandıktan sonraki 12 aylık takip süresinde tüm hastaların tekrar eden AF'leri değerlendirildi. Hastalar AF rekürrens gelişimine göre 2 gruba ayrıldı (AF rekürrens grubu (n=19) ve sinüs ritim grubu (n=7)) ve bu gruplar, AF rekür-renslerini etkileyebilecek değişkenler açısından karşılaştırıldı. Atriyal fibrilasyon rekürrensinin bağımsız öngördürücülerinin belirlenmesinde basamaklı lojistik regresyon analizi ve bağımsız öngördürücülerin kestirim değerinin belirlenmesinde ROC eğrisi analizi kullanıldı. Bulgular: Her iki grubun demografik, klinik ve ekokardiyografik özellikleri benzerdi. Atriyal fibrilasyonu tekrarlayan hastaların PWD değerleri sinüs ritmi devam eden hastalara göre anlamlı olarak daha yüksekti (sırasıyla 80±21 msn ve 53±11 msn, p=0.001). P dalga dispersiyonundaki artış ile AF'nin tekrarlama riski arasında pozitif korelasyon izlendi (r=0.643; p<0.001).Lojistik regresyon analizinde PWD AF rekürrensinin bağımsız ABSTRACT Objective: P-wave dispersion (PWD) is an electrocardiographic measurement, which reflects a disparity in an atrial conduction. In this study, we aim to demonstrate the diagnostic accuracy of PWD in predicting recurrence of atrial fibrillation (AF) in patients with sinus rhythm restoration after external cardioversion. Methods: This prospective, observational study consists of 26 patients, who underwent external cardioversion for non-valvular persistent AF and successfully cardioverted to sinus rhythm (13 men, mean age 58.1±11 years). Twelve-lead surface electrocardiogram of each patient was recorded immediately after the external cardioversion process to measure the P-wave duration. Recurrent AF was assessed for each patient during the 12-month follow-up after restoring the sinus rhythm. Patients were divided into the 2 groups with respect to the AF recurrence (recurrent AF group, (n=19), and sinus rhythm group, (n=7)) and variables that can affect AF development were compared between the two groups.Stepwise logistic regression analysis was used to identify the independent predictors of AF recurrence and ROC curve analysis was performed to determine the cut-off value of independent factors. Results: The two groups have similar demographic, clinical and echocardiographic features. Patients with recurrent AF had significantly higher PWD than those who continued to have a sinus rhythm (80±21 msec vs 53±11 msec, p=0.001, respectively). There is ...

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“…описали взаимо-связь сроков восстановления механической функции ЛП с длительностью ФП: при «коротких» пароксизмах ФП (до 2 нед) восстановление механической функции происходило в течение 24 час, при «умеренных» па-роксизмах ФП (2-6 нед) -в течение 1 нед, а при про-должительности ФП более 6 нед -в течение 1 мес. Так-же авторы пытались проследить связь возникновения и продолжительности электромеханической диссо-циации с методом восстановления синусового ритма [17], хотя есть данные и об отсутствии влияния данных факторов на продолжительность станнинга предсердий [18].…”

Section: Discussionunclassified

The Prediction of Atrial Fibrillation Recurrence at Various Methods of Sinus Rhythm Recovery

Gromyko

Sayganov

2016

Racionalʹnaâ farmakoterapiâ v kardiologii

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Echocardiographic Parameters for Predicting Maintenance of Sinus Rhythm After Internal Atrial Defibrillation

Cited by 55 publications

References 19 publications

Assessing Atrial Mechanical Remodeling and Its Consequences

Assessing Atrial Mechanical Remodeling and Its Consequences

Diagnostic accuracy of P-wave dispersion in prediction of maintenance of sinus rhythm after external cardioversion of atrial fibrillation

The Prediction of Atrial Fibrillation Recurrence at Various Methods of Sinus Rhythm Recovery

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