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A decrease of enlarged left atrium following cardioversion of atrial fibrillation predicts the long-term maintenance
Dariusz A Kosior1, Marcin Szulc, Adam Torbicki
11st Chair and Department of Cardiology.
Kardiologia Polska
|June 2, 2005
Summary
Left atrial enlargement does not prevent successful cardioversion for atrial fibrillation. A decrease in left atrial size within 30 days after cardioversion improves long-term sinus rhythm maintenance.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Echocardiography
Background:
- Left atrial enlargement is a known factor affecting sinus rhythm maintenance after cardioversion for atrial fibrillation.
- However, some studies suggest cardioversion may be effective even in patients with enlarged left atria.
Purpose of the Study:
- To investigate the impact of left atrial enlargement on maintaining sinus rhythm long-term after cardioversion of persistent atrial fibrillation.
Main Methods:
- 104 patients underwent serial antiarrhythmic drug therapy for sinus rhythm restoration.
- Transthoracic echocardiography variables were recorded before cardioversion.
- Generalized additive logistic regression analyzed the effect of left atrial enlargement on sinus rhythm maintenance.
Main Results:
- After one year, 63.5% of patients maintained sinus rhythm.
- Increased left atrial area (>28 cm²) and fractional shortening (26-40%) were associated with sinus rhythm maintenance.
- Patients with enlarged left atria showed a significant decrease in left atrial size within 30 days post-cardioversion.
Conclusions:
- Left atrial enlargement does not necessarily preclude favorable outcomes after cardioversion for atrial fibrillation.
- A reduction in left atrial area within 30 days post-cardioversion supports long-term sinus rhythm maintenance.