The Role of Atrial Myocardial Deformation Parameters in Determining Cardioversion Success in Atrial Fibrillation Patients

Authors

  • Can Ramazan Öncel ALANYA ALAADDIN KEYKUBAT UNIVERSITY, SCHOOL OF MEDICINE
  • Murathan Küçük AKDENIZ UNIVERSITY, SCHOOL OF MEDICINE
  • Aytül Belgi Yıldırım AKDENIZ UNIVERSITY, SCHOOL OF MEDICINE

Abstract

Aim: To investigate the role of left atrial myocardial deformation parameters measured by speckle tracking method in predicting cardioversion success in addition to conventional echocardiographic measurements in cardioversion (CV) planned patients with persistent atrial fibrillation (AF) . Material and Methods: 60 patients scheduled for cardioversion were evaluated and 40 patients with atrial fibrillation were included in the study. Patients with sinus rhythm continuing after 24 hour monitoring were classified as group 1, and patients with AF were classified as group 2. Group 1 patients are divided into 2 groups according to 1st month ECG, as sinus rhythm maintained group and AF detected group. Results: The global left atrial strain S ( LA S-S) and the global left atrial strain rate S ( LA SR-S) measured before and after cardioversion were found to be significantly lower in the group with failed cardioversion (group 2) than those with successful group (group 1). The predictive value of LAVI value in cardioversion success was found to be 39 mL/m². At first month; LA SR-S measured before and after cardioversion in the maintained sinus rhythm group was significantly higher than the atrial fibrillation recurrence group. Also; the LA S-S, measured after cardioversion, was found to be significantly higher in the maintained sinus rhythm group. Conclusion: We showed that atrial myocardial deformation parameters could play role in determining CV success in patients with persistant atrial fibrillation. In addition; we determined that the LA SR-S value was as sensitive and specific parameter as LAVI in predicting cardioversion success.

Author Biographies

Can Ramazan Öncel, ALANYA ALAADDIN KEYKUBAT UNIVERSITY, SCHOOL OF MEDICINE

CARDIOLOGY

Murathan Küçük, AKDENIZ UNIVERSITY, SCHOOL OF MEDICINE

CARDIOLOGY

Aytül Belgi Yıldırım, AKDENIZ UNIVERSITY, SCHOOL OF MEDICINE

CARDIOLOGY

References

Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001; 86: 516– 21.

Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370–5.

AFFIRM Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 2002; 347: 1825–33.

Aime Sempe C, Folliguet T , Rucker Martin C. Myocardial cell death in fibrillating and dilated human right atria. J Am Coll Cardiol 1999; 34: 1577-86

Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal 2010; 31: 2369–429.

Saraiva R , Demirkol S , Buakhamsri A, Greenberg N, Popović ZB, Thomas JD, et al. Left Atrial Strain Measured by Two-Dimensional Speckle Tracking Represents a New Tool to Evaluate Left Atrial Function. J Am Soc Echocardiogr 2010; 23 :172-80

Zipes DP. Atrial Fibrillation.A Tachycardia-Induced Atrial Cardiomyopathy. Circulation 1997; 95: 562-64

Di Salvo G, Caso P, Piccolo R, Fusco A, Martiniello AR, Russo MG, et al. Atrial Myocardial Deformation Properties Predict Maintanance of Sinus Rhythm After External Cardioversion of Recent – Onset Lone Atrial Fibrillation : A Color Doppler Myocardial Imaging and Transthoracic and Transesophageal Echocardiographic Study. Circulation 2005; 112: 387-95.

Türeli Oktay H. The role of atrial myocardial functions in predicting the recurrence of atrial fibrillation before and after cardioversion. Istanbul: Maltepe Univ. 2009.

Wang T, Wang M, Fung JW, Yip GW, Zhang Y, Ho PP,et al. Atrial strain rate echocardiography can predict success or failure of cardioversion for atrial fibrillation: a combined transthoracic tissue Doppler and transoesophageal imaging study. Int J Cardiol 2007; 114: 202-9

Inaba Y, Yuda S, Kobayashi N, Hashimoto A, Uno K, Nakata T, et al. Strain rate imaging for noninvasive functional quantification of the left atrium: comparative studies in controls and patients with atrial fibrillation. J Am Soc Echocardiogr 2005; 18: 729-36

Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP. Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr 2009; 22: 299-305.

Cameli M, Lisi M, Righini FM, Focardi M, Alfieri O, Mondillo S. Left atrial speckle tracking analysis in patients with mitral insufficiency and history of paroxysmal atrial fibrillation. Int J Cardiovasc Imaging 2012; 28: 1663-70

Gabrielli L, Corbalan R, Córdova S, Enríquez A, Mc Nab P, Verdejo HE,et al. Left atrial dysfunction is a predictor of postcoronary artery bypass atrial fibrillation: association of left atrial strain and strain rate assessed by speckle tracking. Echocardiography 2011; 28: 1104-8.

Hwang HJ, Choi EY, Rhee SJ, Joung B, Lee BH, Lee SH, et al. Left atrial strain as predictor of successful outcomes incatheter ablation for atrial fibrillation: a two-dimensional myocardial imagingstudy. J Interv Card Electrophysiol 2009; 26: 127-32.

Mirza M, Caracciolo G, Khan U, Mori N, Saha SK, Srivathsan K, et al. Left atrial reservoir function predicts atrial fibrillation recurrence after catheter ablation: a two-dimensional speckle strain study. J Interv Card Electrophysiol 2011; 31: 197-206

McManus DD, Shaikh AY, Abhishek F, Vasan RS. Atrial fibrillation and heart failure parallels: lessons for atrial fibrillation prevention. Crit Pathw Cardiol 2011; 10: 46–51.

Thijssen VL, Ausma J, Borgers M. Structural remodeling during chronic atrial fibrillation: act of programmed cell survival. Cardiovasc Res 2001; 52: 14–24.

Shaikh AY, Maan A, Khan UA, Aurigemma GP, Hill JC, Kane JL,et al. Speckle echocardiographic left atrial strain and stiffness index as predictors of maintenance of sinus rhythm after cardioversion for atrial fibrillation: a prospective study. Cardiovascular Ultrasound 2012; 10:48.

Tsai WC, Lee CH, Lin CC, Liu YW, Huang YY, Li WT,et al. Association of Left Atrial Strain and Strain Rate Assessed by Speckle Tracking Echocardiography with Paroxysmal Atrial Fibrillation. Echocardiography 2009; 26: 1188-94.

Hammerstingl C, Schwekendiek M, Momcilovic D, Schueler R, Sinning JM, Schrickel JW,et al.Left atrial deformation imaging with ultrasound based two-dimensional speckle-tracking predicts the rate of recurrence of paroxysmal and persistent atrial fibrillation after successful ablation procedures. J Cardiovasc Electrophysiol 2012; 23: 247-55.

Schneider C, Malisius R, Krause K, Lampe F, Bahlmann E, Boczor S, et al. Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Heart J 2008; 29: 1397–1409.

Thomas L, McKay T, Byth K, Marwick TH. Abnormalities of left atrial function after CV: an atrial strain rate study. Heart 2007; 93: 89–95.

Marchese P, Bursi F, Donne GD, Malavasi V, Casali E, Barbieri A, et al. Indexed left atrial volume predicts the recurrence of non-valvular atrial fibrillation after successful cardioversion. European J of Echo 2011; 12: 214-21.

Toh N, Kanzaki H, Nakatani S, Ohara T, Kim J, Kusano KF et al. Left atrial volume combined with atrial pump function identifies hypertensive patients with a history of poroxysmal atrial fibrillation.Hypertension 2010; 55: 1150-56.

Kahan T, Bergfeldt L. Left ventricular hypertrophy in hypertension: its arrhythmogenic potential. Heart 2005; 91: 250-6.

Lalande S, Johnson BD. Diastolic dysfunction: a link between hypertension and heart failure. Drugs Today (Barc) 2008; 44: 503-13.

Eshoo S, Ross DL, Thomas L. Impact of mild hypertension on left atrial size and function. Circ Cardiovasc Imaging 2009; 2: 93-9.

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Published

21.06.2019

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Original Research