Left Atrial Electromechanical Conduction Time Can Predict Six-Month Maintenance of Sinus Rhythm After Electrical Cardioversion in Persistent Atrial Fibrillation by Doppler Tissue Echocardiography

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Abstract

Background: The purpose of this study was to determine whether atrial electromechanical conduction time (EMT) measured by echocardiography can predict 6-month maintenance of sinus rhythm (SR) after electrical cardioversion in patients with atrial fibrillation (AF). Methods: Fifty-three patients with persistent AF (>1 month) who had successful cardioversion and 30 controls with SR were prospectively enrolled. SR maintenance was assessed during 6-month follow-up. EMT was measured as the time interval from the onset of the P wave on electrocardiography to the peak of the late diastolic wave from the septal and lateral mitral annulus (EMT-S and EMT-L, respectively) and the lateral tricuspid annulus (EMT-T) on tissue Doppler echocardiography. Results: Compared with controls, left atrial (LA) volume index, P-wave duration, and EMT were significantly larger in patients with AF (all P values < .001). In patients with AF, the duration of AF (P = .71) and P-wave duration (P = .24) were not different between the SR maintenance group (n = 23) and the AF recurrence group (n = 30), and there was a trend toward increased LA volume index in the AF recurrence group (47.0 ± 12.4 vs 45.3 ± 12.6 mL/m2, P = .07). EMT-S and EMT-L were significantly larger in the AF recurrence group (131.4 ± 20.9 vs 116.3 ± 15.5 ms, P = .005, and 152.2 ± 15.7 vs 128.9 ± 13.8 ms, P < .001, respectively), but not EMT-T. EMT-S and EMT-L were related to LA volume index (r = .36, P = .008, and r = .33, P = .02, respectively). On multivariate logistic regression analysis, only EMT-L was an independent predictor of identifying patients who remained in SR (P < .001), and the sensitivity and specificity for the prediction of 6-month maintenance of restored SR were 82.6% and 83.3% using a cutoff value of EMT-L ≤ 138.0 ms (odds ratio, 0.862; 95% confidence interval, 0.788-0.942; P = .001). Conclusion: LA EMT was significantly prolonged in patients with recurring AF, indicating significantly depressed atrial conduction in enlarged LA, and can predict 6-month maintenance of SR after electrical cardioversion.

Original languageEnglish
Pages (from-to)309-314
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume23
Issue number3
DOIs
Publication statusPublished - 2010 Mar 1

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Electric Countershock
Doppler Echocardiography
Atrial Fibrillation
Maintenance
Recurrence

Keywords

  • Atrial fibrillation
  • Cardioversion
  • Electromechanical conduction time
  • Tissue Doppler echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{4d531a0b725e4c8d90482107df1653eb,
title = "Left Atrial Electromechanical Conduction Time Can Predict Six-Month Maintenance of Sinus Rhythm After Electrical Cardioversion in Persistent Atrial Fibrillation by Doppler Tissue Echocardiography",
abstract = "Background: The purpose of this study was to determine whether atrial electromechanical conduction time (EMT) measured by echocardiography can predict 6-month maintenance of sinus rhythm (SR) after electrical cardioversion in patients with atrial fibrillation (AF). Methods: Fifty-three patients with persistent AF (>1 month) who had successful cardioversion and 30 controls with SR were prospectively enrolled. SR maintenance was assessed during 6-month follow-up. EMT was measured as the time interval from the onset of the P wave on electrocardiography to the peak of the late diastolic wave from the septal and lateral mitral annulus (EMT-S and EMT-L, respectively) and the lateral tricuspid annulus (EMT-T) on tissue Doppler echocardiography. Results: Compared with controls, left atrial (LA) volume index, P-wave duration, and EMT were significantly larger in patients with AF (all P values < .001). In patients with AF, the duration of AF (P = .71) and P-wave duration (P = .24) were not different between the SR maintenance group (n = 23) and the AF recurrence group (n = 30), and there was a trend toward increased LA volume index in the AF recurrence group (47.0 ± 12.4 vs 45.3 ± 12.6 mL/m2, P = .07). EMT-S and EMT-L were significantly larger in the AF recurrence group (131.4 ± 20.9 vs 116.3 ± 15.5 ms, P = .005, and 152.2 ± 15.7 vs 128.9 ± 13.8 ms, P < .001, respectively), but not EMT-T. EMT-S and EMT-L were related to LA volume index (r = .36, P = .008, and r = .33, P = .02, respectively). On multivariate logistic regression analysis, only EMT-L was an independent predictor of identifying patients who remained in SR (P < .001), and the sensitivity and specificity for the prediction of 6-month maintenance of restored SR were 82.6{\%} and 83.3{\%} using a cutoff value of EMT-L ≤ 138.0 ms (odds ratio, 0.862; 95{\%} confidence interval, 0.788-0.942; P = .001). Conclusion: LA EMT was significantly prolonged in patients with recurring AF, indicating significantly depressed atrial conduction in enlarged LA, and can predict 6-month maintenance of SR after electrical cardioversion.",
keywords = "Atrial fibrillation, Cardioversion, Electromechanical conduction time, Tissue Doppler echocardiography",
author = "Seong-Mi Park and Kim, {Yong Hyun} and Jongil Choi and Pak, {Hui Nam} and Kim, {Young Hoon} and Shim, {Wan Joo}",
year = "2010",
month = "3",
day = "1",
doi = "10.1016/j.echo.2009.12.019",
language = "English",
volume = "23",
pages = "309--314",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Left Atrial Electromechanical Conduction Time Can Predict Six-Month Maintenance of Sinus Rhythm After Electrical Cardioversion in Persistent Atrial Fibrillation by Doppler Tissue Echocardiography

AU - Park, Seong-Mi

AU - Kim, Yong Hyun

AU - Choi, Jongil

AU - Pak, Hui Nam

AU - Kim, Young Hoon

AU - Shim, Wan Joo

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Background: The purpose of this study was to determine whether atrial electromechanical conduction time (EMT) measured by echocardiography can predict 6-month maintenance of sinus rhythm (SR) after electrical cardioversion in patients with atrial fibrillation (AF). Methods: Fifty-three patients with persistent AF (>1 month) who had successful cardioversion and 30 controls with SR were prospectively enrolled. SR maintenance was assessed during 6-month follow-up. EMT was measured as the time interval from the onset of the P wave on electrocardiography to the peak of the late diastolic wave from the septal and lateral mitral annulus (EMT-S and EMT-L, respectively) and the lateral tricuspid annulus (EMT-T) on tissue Doppler echocardiography. Results: Compared with controls, left atrial (LA) volume index, P-wave duration, and EMT were significantly larger in patients with AF (all P values < .001). In patients with AF, the duration of AF (P = .71) and P-wave duration (P = .24) were not different between the SR maintenance group (n = 23) and the AF recurrence group (n = 30), and there was a trend toward increased LA volume index in the AF recurrence group (47.0 ± 12.4 vs 45.3 ± 12.6 mL/m2, P = .07). EMT-S and EMT-L were significantly larger in the AF recurrence group (131.4 ± 20.9 vs 116.3 ± 15.5 ms, P = .005, and 152.2 ± 15.7 vs 128.9 ± 13.8 ms, P < .001, respectively), but not EMT-T. EMT-S and EMT-L were related to LA volume index (r = .36, P = .008, and r = .33, P = .02, respectively). On multivariate logistic regression analysis, only EMT-L was an independent predictor of identifying patients who remained in SR (P < .001), and the sensitivity and specificity for the prediction of 6-month maintenance of restored SR were 82.6% and 83.3% using a cutoff value of EMT-L ≤ 138.0 ms (odds ratio, 0.862; 95% confidence interval, 0.788-0.942; P = .001). Conclusion: LA EMT was significantly prolonged in patients with recurring AF, indicating significantly depressed atrial conduction in enlarged LA, and can predict 6-month maintenance of SR after electrical cardioversion.

AB - Background: The purpose of this study was to determine whether atrial electromechanical conduction time (EMT) measured by echocardiography can predict 6-month maintenance of sinus rhythm (SR) after electrical cardioversion in patients with atrial fibrillation (AF). Methods: Fifty-three patients with persistent AF (>1 month) who had successful cardioversion and 30 controls with SR were prospectively enrolled. SR maintenance was assessed during 6-month follow-up. EMT was measured as the time interval from the onset of the P wave on electrocardiography to the peak of the late diastolic wave from the septal and lateral mitral annulus (EMT-S and EMT-L, respectively) and the lateral tricuspid annulus (EMT-T) on tissue Doppler echocardiography. Results: Compared with controls, left atrial (LA) volume index, P-wave duration, and EMT were significantly larger in patients with AF (all P values < .001). In patients with AF, the duration of AF (P = .71) and P-wave duration (P = .24) were not different between the SR maintenance group (n = 23) and the AF recurrence group (n = 30), and there was a trend toward increased LA volume index in the AF recurrence group (47.0 ± 12.4 vs 45.3 ± 12.6 mL/m2, P = .07). EMT-S and EMT-L were significantly larger in the AF recurrence group (131.4 ± 20.9 vs 116.3 ± 15.5 ms, P = .005, and 152.2 ± 15.7 vs 128.9 ± 13.8 ms, P < .001, respectively), but not EMT-T. EMT-S and EMT-L were related to LA volume index (r = .36, P = .008, and r = .33, P = .02, respectively). On multivariate logistic regression analysis, only EMT-L was an independent predictor of identifying patients who remained in SR (P < .001), and the sensitivity and specificity for the prediction of 6-month maintenance of restored SR were 82.6% and 83.3% using a cutoff value of EMT-L ≤ 138.0 ms (odds ratio, 0.862; 95% confidence interval, 0.788-0.942; P = .001). Conclusion: LA EMT was significantly prolonged in patients with recurring AF, indicating significantly depressed atrial conduction in enlarged LA, and can predict 6-month maintenance of SR after electrical cardioversion.

KW - Atrial fibrillation

KW - Cardioversion

KW - Electromechanical conduction time

KW - Tissue Doppler echocardiography

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U2 - 10.1016/j.echo.2009.12.019

DO - 10.1016/j.echo.2009.12.019

M3 - Article

C2 - 20138472

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SP - 309

EP - 314

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

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