Predicting Early Atrial Fibrillation Recurrence Post-Electrical Cardioversion: A Critical Look at Bilateral Atrial...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Imaging

Background:

• Atrial fibrillation (AF) recurrence after electrical cardioversion (ECV) is linked to atrial morpho-functional changes.
• Identifying predictors of AF recurrence post-ECV is crucial for patient management.

Purpose of the Study:

• To identify predictors of atrial fibrillation recurrence after successful electrical cardioversion.

Main Methods:

• Sixty-one patients undergoing elective ECV with successful sinus rhythm conversion were assessed.
• Cardiovascular assessment, including LA strain, TDI Doppler, RAVi, and Aix75, was performed immediately post-ECV.
• Patients were followed for 6 months to determine AF recurrence.

Main Results:

• AF recurrence was observed in 39.3% of patients at 6-month follow-up.
• Non-recurrence was associated with lower right atrial valvular index (RAVi), higher left atrial (LA) strain S-R, and more pronounced Doppler velocities (a' waves).
• A scoring system based on RAVi, average a' wave, and LA strain S-R demonstrated high accuracy (AUC 0.81) in predicting AF recurrence.

Conclusions:

• Left atrial strain, TDI Doppler parameters, RAVi, and Aix75 are independent predictors of AF recurrence post-ECV.
• These parameters, measured immediately after ECV, can aid in stratifying patients at higher risk for AF recurrence.