Document Detail


Left atrial asynchrony is a major predictor of 1-year recurrence of atrial fibrillation after electrical cardioversion.
MedLine Citation:
PMID:  20445461     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The level of atrial mechanical asynchrony may vary within the atrial fibrillation population and this may have pathophysiological relevance. OBJECTIVE: We sought to verify whether the degree of left-atrial mechanical asynchrony associated with atrial fibrillation is a predictor of arrhythmia recurrence after restoration of sinus rhythm with electrical cardioversion. METHODS AND RESULTS: Left atrial volume was calculated, whereas two-dimensional (2D) strain (speckle tracking technique) was used to estimate peak and standard deviation (SD) of time-to-peak of deformation of six segments arbitrarily identified along the perimeter of the cavity, imaged in apical four-chamber view. Left atrial mechanical asynchrony was quantified according to quartiles of time-to-peak SD assuming that larger values would identify higher grades of asynchrony. A total of 130 patients undergoing cardioversion for atrial fibrillation were prospectively enrolled. Time-to-peak SD was inversely related with peak strain (P < 0.001). No differences were observed among groups in terms of clinical, therapeutical and additional echocardiographic variables. At 1-year atrial fibrillation was observed in 53% of patients, with time-to-peak SD linearly related to atrial-fibrillation recurrence (P = 0.014). At multivariate analysis only time-to-peak SD (P = 0.032), but not atrial volume (P = 0.075), was identified as an independent predictor of fibrillation recurrence. CONCLUSION: This is the first study showing that left atrial asynchrony, quantified as time-to-peak SD of regional atrial strains before electrical cardioversion, is a major independent predictor of fibrillation recurrence in patients back to sinus-rhythm postprocedure.
Authors:
Elisa Rondano; Gabriele Dell'Era; Giuseppe De Luca; Cristina Piccinino; Giorgio Bellomo; Paolo N Marino
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  499-506     Citation Subset:  IM    
Affiliation:
Cardiology Clinic and General Pathology, Eastern Piedmont University, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrial Fibrillation / physiopathology,  therapy*,  ultrasonography
Atrial Function, Left*
Chi-Square Distribution
Echocardiography, Doppler, Color
Electric Countershock*
Female
Humans
Linear Models
Logistic Models
Male
Middle Aged
Prospective Studies
Recurrence
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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