Predictive value of atrial electromechanical delay for atrial fibrillation recurrence

Hasan Ari, Selma Ari, Mehmet Akkaya, Cihan Aydin, Nadir Emlek, O. Yaşar Sarigül, Seçkin Çetinkaya, Tahsin Bozat, Muhammet Şentürk, Kemal Karaaǧaç, Mehmet Melek, Mustafa Yilmaz

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21 Scopus citations

Abstract

Background: We investigated the predictive value of atrial electromechanical delay (AEMD) for recurrence of atrial fibrillation (AF) at 1-month after cardioversion. Methods: Seventy-seven patients with persistent AF were evaluated and finally 50 patients (12 men, 38 women) were included. All patients underwent transthoracic electrical DC cardioversion under amiodarone treatment. AEMD was measured as the time interval from the onset of the P wave on electrogram (ECG) to the beginning of late diastolic wave (Am) from the ventricular annulus and atrial walls on tissue Doppler imaging, in the apical 4-chamber view 24 h after cardiversion. P wave maximum-duration (Pmax), P wave minimum-duration (Pmin) and P wave dispersion-duration (Pdis) were calculated on the 12-lead ECG at 24-h postcardioversion. We followed the heart rate and rhythm by 12-lead ECG at 24-h, 1-week and 1-month. Results: At 1-month follow-up after cardioversion, 28 (56%) patients were in sinus rhythm (SR), whereas 22 (44%) patients reverted to AF. The AEMD durations were longer in AF group than SR group (p < 0.001) and were significantly correlated with Pmax and Pdis (p < 0.001 for both). For AF recurrence; duration of AF, left atrial (LA) diameter, maximum LA volume index, mitral A velocity and LA lateral AEMD were significant parameters in univariate-analysis, however LA lateral AEMD was the only significant parameter in multivariate-analysis (OR: 1.46; 95% CI 1.02-2.11; p = 0.03). Conclusions: Our results suggest that AEMD is associated with an increased risk of recurrence of AF within 1-month. These data may have implications for the identification of patients who are most likely to experience substantial benefit from cardiversion therapy for AF.

Original languageEnglish (US)
Pages (from-to)639-647
Number of pages9
JournalCardiology Journal
Volume20
Issue number6
DOIs
StatePublished - Dec 20 2013

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Ari, H., Ari, S., Akkaya, M., Aydin, C., Emlek, N., Yaşar Sarigül, O., Çetinkaya, S., Bozat, T., Şentürk, M., Karaaǧaç, K., Melek, M., & Yilmaz, M. (2013). Predictive value of atrial electromechanical delay for atrial fibrillation recurrence. Cardiology Journal, 20(6), 639-647. https://doi.org/10.5603/CJ.2013.0164