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Left atrial appendage outflow velocity index is superior to conventional criteria for prediction of maintenance of sinus rhythm after cardioversion. An echocardiographic study in patients with atrial fibrillation of a few months' duration

Roijer, Anders LU ; Meurling, Carl LU ; Eskilsson, Jan LU and Olsson, Bertil LU (2001) In Scandinavian Cardiovascular Journal 35(2). p.119-124
Abstract
OBJECTIVE: To investigate whether left atrial appendage outflow velocity alone or in relation to left atrial diameter is a superior predictor of sinus rhythm maintenance after cardioversion compared with traditional clinical or echocardiography parameters. DESIGN: Sixty-two patients with their first episode of atrial fibrillation were examined using echocardiography before DC-cardioversion. At one month's follow-up, 42 patients had maintained sinus rhythm (group A), and 20 had relapsed into atrial fibrillation (group B). There were no differences in arrhythmia duration or antiarrhythmic therapy between the groups. RESULTS: Left atrial diameter measured by echocardiography was smaller in group A (42 mm, 95% CI 40.9-44.1 mm) compared with... (More)
OBJECTIVE: To investigate whether left atrial appendage outflow velocity alone or in relation to left atrial diameter is a superior predictor of sinus rhythm maintenance after cardioversion compared with traditional clinical or echocardiography parameters. DESIGN: Sixty-two patients with their first episode of atrial fibrillation were examined using echocardiography before DC-cardioversion. At one month's follow-up, 42 patients had maintained sinus rhythm (group A), and 20 had relapsed into atrial fibrillation (group B). There were no differences in arrhythmia duration or antiarrhythmic therapy between the groups. RESULTS: Left atrial diameter measured by echocardiography was smaller in group A (42 mm, 95% CI 40.9-44.1 mm) compared with group B (46 mm, 95% CI 43.4-48.2, p < 0.05). Patients in group A had a higher left atrial appendage outflow velocity at 0.44 m/s (95% CI 0.39-0.49) compared with 0.34 m/s (95% CI 0.30-0.37) in group B (p < 0.01). The ratio of left atrial appendage flow to left atrial diameter was 0.011 (95% CI 0.009-0.012) in group A compared with 0.008 (95% CI 0.007-0.009) in group B, and 63% (95% CI 33-78) of the patients in group A had velocity ratio >0.009 compared with 20% (95% CI 2-38) in group B, (p < 0.01). Stepwise multiple logistic regression analysis showed that a velocity ratio >0.009 was the only predictor for maintenance of sinus rhythm one month after cardioversion with an odds ratio of 6.4 (95% CI 1.9-23.8), (p = 0.004). CONCLUSION: The ratio of left atrial appendage outflow velocity to left atrial diameter is superior to the traditionally used criteria for prediction of maintenance of sinus rhythm following DC-conversion of first-episode atrial fibrillation. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Cardiovascular Journal
volume
35
issue
2
pages
119 - 124
publisher
Taylor & Francis
external identifiers
  • pmid:11405487
  • scopus:0035020607
ISSN
1651-2006
DOI
10.1080/140174301750164817
language
English
LU publication?
yes
id
9f14318c-ea63-48fe-8158-52a404c3204a (old id 1123199)
date added to LUP
2016-04-01 16:49:41
date last changed
2022-01-28 22:28:32
@article{9f14318c-ea63-48fe-8158-52a404c3204a,
  abstract     = {{OBJECTIVE: To investigate whether left atrial appendage outflow velocity alone or in relation to left atrial diameter is a superior predictor of sinus rhythm maintenance after cardioversion compared with traditional clinical or echocardiography parameters. DESIGN: Sixty-two patients with their first episode of atrial fibrillation were examined using echocardiography before DC-cardioversion. At one month's follow-up, 42 patients had maintained sinus rhythm (group A), and 20 had relapsed into atrial fibrillation (group B). There were no differences in arrhythmia duration or antiarrhythmic therapy between the groups. RESULTS: Left atrial diameter measured by echocardiography was smaller in group A (42 mm, 95% CI 40.9-44.1 mm) compared with group B (46 mm, 95% CI 43.4-48.2, p &lt; 0.05). Patients in group A had a higher left atrial appendage outflow velocity at 0.44 m/s (95% CI 0.39-0.49) compared with 0.34 m/s (95% CI 0.30-0.37) in group B (p &lt; 0.01). The ratio of left atrial appendage flow to left atrial diameter was 0.011 (95% CI 0.009-0.012) in group A compared with 0.008 (95% CI 0.007-0.009) in group B, and 63% (95% CI 33-78) of the patients in group A had velocity ratio &gt;0.009 compared with 20% (95% CI 2-38) in group B, (p &lt; 0.01). Stepwise multiple logistic regression analysis showed that a velocity ratio &gt;0.009 was the only predictor for maintenance of sinus rhythm one month after cardioversion with an odds ratio of 6.4 (95% CI 1.9-23.8), (p = 0.004). CONCLUSION: The ratio of left atrial appendage outflow velocity to left atrial diameter is superior to the traditionally used criteria for prediction of maintenance of sinus rhythm following DC-conversion of first-episode atrial fibrillation.}},
  author       = {{Roijer, Anders and Meurling, Carl and Eskilsson, Jan and Olsson, Bertil}},
  issn         = {{1651-2006}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{119--124}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Left atrial appendage outflow velocity index is superior to conventional criteria for prediction of maintenance of sinus rhythm after cardioversion. An echocardiographic study in patients with atrial fibrillation of a few months' duration}},
  url          = {{http://dx.doi.org/10.1080/140174301750164817}},
  doi          = {{10.1080/140174301750164817}},
  volume       = {{35}},
  year         = {{2001}},
}