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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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Factors determining long-term maintenance of sinus rhythm after cardioversion of persistent atrial fibrillation

Dariusz Kosior1, Marian Szulc, Radosław Piatkowski

  • 1Chair and Department of Cardiology, Medical University of Warsaw, Poland.

Kardiologia Polska
|October 16, 2003
PubMed

Insights

Maintaining sinus rhythm after atrial fibrillation cardioversion is possible. Smaller left atrial area and increased left ventricular fractional shortening predict successful long-term sinus rhythm maintenance.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Maintaining sinus rhythm (SR) after cardioversion (CV) for persistent atrial fibrillation (AF) reduces stroke risk and anticoagulation complications.
  • Identifying predictors for SR maintenance is crucial for patient management.

Purpose of the Study:

  • To identify clinical and echocardiographic predictors of maintaining SR for one year post-CV in persistent AF patients.
  • To compare echocardiographic parameters between patients who maintained SR and those with AF recurrence.

Main Methods:

  • A randomized controlled trial involving 104 patients with persistent AF undergoing CV.
  • Transthoracic echocardiography performed before CV.
  • Linear and logistic regression analysis to compare echocardiographic data and predict SR maintenance over 12 months.

Main Results:

  • Sinus rhythm was maintained in 63.5% of patients at one-year follow-up.
  • A smaller left atrial area (<28 cm²) was significantly associated with SR maintenance (p<0.02; RR 1.72).
  • Increased left ventricular fractional shortening (25-40%) also predicted SR maintenance (p<0.05; RR 1.2).

Conclusions:

  • Left atrial area and left ventricular fractional shortening are independent predictors of SR maintenance after successful CV in persistent AF.
  • These echocardiographic parameters can aid in stratifying patients likely to maintain SR.
Abstract

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