[Usefulness of selected echocardiographic parameters at prognosing recurrence of nonrheumatic atrial fibrillation]

Recurrence of atrial fibrillation (FA) is very important problem after sinus rhythm (SR) restoration. The aim of study was to determinate a correlation between FA recurrence and echocardiographic parameters.

In 98 patients (40 women and 58 men, age 36 do 86, mean 64.72 +/- 10.43 years) with nonrheumatic FA the SR was restored. For left atrium (LA) and its appendage (LAA) assessment the transthoracical (TTE) and transesophageal (TEE) echocardiography were performed during first hour of SR. At the TTE the following parameters were measured: LAmax, LAshort, LAlong, LAarea, LAcirc. During TEE were recorded: LAAshort, LAAlong, LAAcirc, LAAarea, LAAF, LAAB, LAAFintg, LAABintg. Immediately after reversion of FA the Holter recording was started.

In 14 patients FA recurred during 24 hours after cardioversion. In 6 patients FA only short episodes were noted, in the others 8 patients arrhythmia was remained at the end of Holter recordings. Among patients with arrhythmia recurrence during first 24 hours significantly larger LA max, LA short, LAA short and LAA area were measured when compared with patients who maintained sinus rhythm. Most of Doppler echocardiographic parameters measured after SR restoration evidenced better LA performance collarated with improved LA hemodynamic function. LA max and LA short were significantly smaller in patients with sustained SR 6 months follow up than in patients who had recurrence of FA. Most of Doppler echocardiographic parameters characterising LA function were meaningly higher in patient who maintained SR after arrhythmia termination. Similarly LAAF, LAAB, LAAF intg and LAAB intg had significantly greater values than in patients with recurrence of FA during 6-months observation. Spontaneous echocardiographic contrast occurrence both before and after SR restoration coexisted with arrhythmia return either during first 24 hours and 6-months follow-up.

FA recurrence is connected with LA and LAA enlargement. The LAA function assessed just after SR restoration is not a good predictor of SR stabilization. Long term SR stabilization is related to smaller LA an LAA diameters and theirs better hemodynamic function as well during FA as after arrhythmia termination.