Left Ventricular Mechanics Are Associated with Short-Term Sinus Rhythm Maintenance After Electrical Cardioversion in
Beata Uziębło-Życzkowska1, Paulina Skalska1, Marek Kiliszek1
1Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland.
Journal of Cardiovascular Development and Disease
|March 27, 2026
Summary
Electrical cardioversion (ECV) improves heart function after atrial fibrillation (AF) restoration. Baseline left ventricular (LV) mechanics may predict short-term rhythm success, while atrial function improves post-procedure.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Echocardiography
Background:
- Electrical cardioversion (ECV) is a key treatment for restoring sinus rhythm (SR) in atrial fibrillation (AF).
- The extent of atrioventricular remodeling and factors influencing short-term SR maintenance post-ECV require further elucidation.
- This study investigates echocardiographic changes and SR persistence determinants after ECV.
Purpose of the Study:
- To evaluate echocardiographic changes in atrioventricular function following ECV.
- To identify parameters associated with the maintenance of SR after ECV.
- To explore the relationship between baseline cardiac mechanics and short-term rhythm control.
Main Methods:
- Prospective enrollment of 94 patients undergoing elective ECV.
- Comprehensive echocardiography performed pre-procedure, 24 hours post-procedure, and 30 days post-procedure.
- Non-parametric and exploratory statistical analyses due to sample size and data distribution limitations.
Main Results:
- SR was maintained in 76% of patients at 24 hours and 49% at 30 days.
- Sustained SR correlated with improvements in left atrial (LA) reservoir strain, emptying fraction, and stiffness index, indicating reverse atrial remodeling.
- Significant improvements were observed in left ventricular (LV) ejection fraction, global longitudinal strain, and myocardial work indices.
- Baseline LV parameters, including global wasted work and LV end-systolic volume, showed moderate effect sizes and potential association with short-term SR maintenance.
Conclusions:
- Successful ECV leads to significant short-term improvements in atrioventricular functional parameters.
- Exploratory findings suggest baseline LV mechanical parameters may be associated with short-term SR maintenance.
- LA functional parameters primarily reflect reverse remodeling post-rhythm restoration, necessitating larger studies for confirmation.
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