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Echocardiographic and electrocardiographic predictors for atrial fibrillation recurrence following cardioversion

Bollmann, Andreas LU ; Husser, Daniela; Steinert, R.; Stridh, Martin LU ; Sörnmo, Leif LU ; Olsson, Bertil LU ; Polywka, D.; Molling, J.; Geller, C. and Klein, H.U. (2003) In Journal of Cardiovascular Electrophysiology 14(s10). p.162-165
Abstract
Introduction: Identification of suitable candidates for cardioversion currently is not based on individual electrical and mechanical atrial remodeling. Therefore, this study analyzed the meaning of atrial fibrillatory rate obtained from the surface ECG (as a measure of electrical remodeling) and left atrial size (as measure of mechanical remodeling) for prediction of early atrial fibrillation (AF) recurrence following cardioversion.



Methods and Results: Forty-four consecutive patients (26 men and 18 women, mean age 62 ± 11 years, no antiarrhythmic medication at baseline) with persistent AF were studied. Fibrillatory rate was obtained from high-gain, high-resolution surface ECG using digital signal processing (filtering,... (More)
Introduction: Identification of suitable candidates for cardioversion currently is not based on individual electrical and mechanical atrial remodeling. Therefore, this study analyzed the meaning of atrial fibrillatory rate obtained from the surface ECG (as a measure of electrical remodeling) and left atrial size (as measure of mechanical remodeling) for prediction of early atrial fibrillation (AF) recurrence following cardioversion.



Methods and Results: Forty-four consecutive patients (26 men and 18 women, mean age 62 ± 11 years, no antiarrhythmic medication at baseline) with persistent AF were studied. Fibrillatory rate was obtained from high-gain, high-resolution surface ECG using digital signal processing (filtering, QRST subtraction, Fourier analysis) before electrical cardioversion. Univariate and multivariate regression analysis revealed larger systolic left atrial area (Beta = 0.176, P = 0.031) obtained by precardioversion echocardiogram from the apical four-chamber view and higher atrial fibrillatory rate (Beta = 0.029, P = 0.021) to be independent predictors for AF recurrence (n = 13). Stratification based on the regression equation (electromechanical index [EMI]= 0.176 systolic left atrial area + 0.029 fibrillatory rate − 17.674) allowed identification of groups at low, intermediate, or high risk. No patient with an EMI < −1.85 had early AF recurrence, as opposed to 78% with an EMI > −0.25. Intermediate results (40% recurrence rate) were obtained when the calculated EMI ranged between −1.85 and −0.25 (P < 0.001).



Conclusion: Fibrillatory rate obtained from the surface ECG and systolic left atrial area obtained by echocardiography may predict early AF recurrence in patients with persistent AF. These parameters might be useful in identifying candidates with a high likelihood of remaining in sinus rhythm after cardioversion. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardioversion, early recurrence, atrial fibrillation, electrocardiographic signal processing
in
Journal of Cardiovascular Electrophysiology
volume
14
issue
s10
pages
162 - 165
publisher
Wiley-Blackwell
external identifiers
  • wos:000186553900008
  • pmid:14760919
  • scopus:10744230749
ISSN
1540-8167
DOI
language
English
LU publication?
yes
id
179740d1-bfec-42ac-be19-5497cabb139e (old id 295030)
date added to LUP
2007-08-24 12:53:58
date last changed
2018-05-29 10:09:02
@article{179740d1-bfec-42ac-be19-5497cabb139e,
  abstract     = {Introduction: Identification of suitable candidates for cardioversion currently is not based on individual electrical and mechanical atrial remodeling. Therefore, this study analyzed the meaning of atrial fibrillatory rate obtained from the surface ECG (as a measure of electrical remodeling) and left atrial size (as measure of mechanical remodeling) for prediction of early atrial fibrillation (AF) recurrence following cardioversion.<br/><br>
<br/><br>
Methods and Results: Forty-four consecutive patients (26 men and 18 women, mean age 62 ± 11 years, no antiarrhythmic medication at baseline) with persistent AF were studied. Fibrillatory rate was obtained from high-gain, high-resolution surface ECG using digital signal processing (filtering, QRST subtraction, Fourier analysis) before electrical cardioversion. Univariate and multivariate regression analysis revealed larger systolic left atrial area (Beta = 0.176, P = 0.031) obtained by precardioversion echocardiogram from the apical four-chamber view and higher atrial fibrillatory rate (Beta = 0.029, P = 0.021) to be independent predictors for AF recurrence (n = 13). Stratification based on the regression equation (electromechanical index [EMI]= 0.176 systolic left atrial area + 0.029 fibrillatory rate − 17.674) allowed identification of groups at low, intermediate, or high risk. No patient with an EMI &lt; −1.85 had early AF recurrence, as opposed to 78% with an EMI &gt; −0.25. Intermediate results (40% recurrence rate) were obtained when the calculated EMI ranged between −1.85 and −0.25 (P &lt; 0.001).<br/><br>
<br/><br>
Conclusion: Fibrillatory rate obtained from the surface ECG and systolic left atrial area obtained by echocardiography may predict early AF recurrence in patients with persistent AF. These parameters might be useful in identifying candidates with a high likelihood of remaining in sinus rhythm after cardioversion.},
  author       = {Bollmann, Andreas and Husser, Daniela and Steinert, R. and Stridh, Martin and Sörnmo, Leif and Olsson, Bertil and Polywka, D. and Molling, J. and Geller, C. and Klein, H.U.},
  issn         = {1540-8167},
  keyword      = {cardioversion,early recurrence,atrial fibrillation,electrocardiographic signal processing},
  language     = {eng},
  number       = {s10},
  pages        = {162--165},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Cardiovascular Electrophysiology},
  title        = {Echocardiographic and electrocardiographic predictors for atrial fibrillation recurrence following cardioversion},
  url          = {http://dx.doi.org/},
  volume       = {14},
  year         = {2003},
}