Predictors for maintenance of sinus rhythm after cardioversion in patients with nonvalvular atrial fibrillation
| Autor: | Deniz Güzelsoy, Haşim Mutlu, Vedat Sansoy, Sinan Üner, M. Serdar Küçükoğlu, Barış Ökçün, Zerrin Yigit |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Electric Countershock Cardioversion Severity of Illness Index Coronary artery disease Cohort Studies Electrocardiography Heart Rate Predictive Value of Tests Recurrence Internal medicine Atrial Fibrillation medicine Mitral valve prolapse Humans Radiology Nuclear Medicine and imaging Sinus rhythm Thrombus Aged Probability Retrospective Studies Fibrillation Aged 80 and over Ejection fraction Chi-Square Distribution business.industry Atrial fibrillation Middle Aged medicine.disease Logistic Models Treatment Outcome Anesthesia Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal Follow-Up Studies |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0742-2822 |
| Popis: | Recurrence of atrial fibrillation (AF) after cardioversion (CV) to sinus rhythm (SR) is determined by various clinical and echocardiographic parameters. Transesophageal echocardiographic (TEE) parameters have been the focus of clinicians' interests for restoring and maintaining SR. This study determined the clinical, transthoracic, and TEE parameters that predict maintenance of SR in patients with nonvalvular AF after CV. We enrolled 173 patients with nonvalvular AF in the study. TEE could not be performed in 26 patients prior to CV. Twenty-five patients had spontaneously CV prior to TEE. Six patients were excluded because of left atrial (LA) thrombus assessed by TEE. CV was unsuccessful in 6 patients. The remaining 110 consecutive patients (56 men, 54 women, mean age 69 +/- 9 years), who had been successfully cardioverted to SR, were prospectively included in the study. Fifty-seven (52%) patients were still in SR 6 months after CV. Age, gender, the configuration of the fibrillation wave on the electrocardiogram, pulmonary venous diastolic flow, and the presence of diabetes, hypertension, coronary artery disease, mitral annulus calcification, and mitral valve prolapse (MVP) did not predict recurrence. Duration of AF, presence of chronic obstructive pulmonary disease (COPD), LA diameter, left ventricular ejection fraction (EF), left atrial appendage peak flow (LAAPF), LAA ejection fraction (LAAEF), pulmonary venous systolic flow (PVSF), and the presence of LA spontaneous echo contrast (LASEC) predicted recurrence of AF 6 months after CV. In multivariate analysis, LAAEF < 30% was found to be the only independent variable (P < 0.0012) predicting recurrence at 6 months after CV in patients with nonvalvular AF. LAAEF more than 30% had a sensitivity of 75% and a specificity of 88% in predicting maintenance of SR 6 months after CV in patients with nonvalvular AF. In conclusion, TEE variables often used to determine thromboembolic risk also might be used to predict the outcome of CV. |
| Databáze: | OpenAIRE |
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