Prediction of sinus rhythm maintenance following DC-cardioversion of persistent atrial fibrillation - The role of atrial cycle length

被引：19

作者：

Meurling C.J. ^{[1
]}

Roijer A. ^{[1
]}

Waktare J.E.P. ^{[2
]}

Holmqvist F. ^{[1
]}

Lindholm C.J. ^{[1
]}

Ingemansson M.P. ^{[1
]}

Carlson J. ^{[1
]}

Stridh M. ^{[3
]}

Sörnmo L. ^{[3
]}

Olsson S.B. ^{[1
]}

机构：

[1] Department of Cardiology, Lund University Hospital

[2] The Cardiothoracic Centre, Liverpool

[3] Department of Applied Electronics, Lund Institute of Technology, Lund

来源：

BMC Cardiovascular Disorders | / 6卷 / 1期

关键词：

Atrial Fibrillation; Sinus Rhythm; Persistent Atrial Fibrillation; Atrial Fibrillation Recurrence; Left Atrial Diameter;

D O I：

10.1186/1471-2261-6-11

中图分类号：

学科分类号：

摘要：

Background: Atrial electrical remodeling has been shown to influence the outcome the outcome following cardioversion of atrial fibrillation (AF) in experimental studies. The aim of the present study was to find out whether a non-invasively measured atrial fibrillatory cycle length, alone or in combination with other non-invasive parameters, could predict sinus rhythm maintenance after cardioversion of AF. Methods: Dominant atrial cycle length (DACL), a previously validated non-invasive index of atrial refractoriness, was measured from lead VI and a unipolar oesophageal lead prior to cardioversion in 37 patients with persistent AF undergoing their first cardioversion. Results: 32 patients were successfully cardioverted to sinus rhythm. The mean DACL in the 22 patients who suffered recurrence of AF within 6 weeks was 152 ± 15 ms (VI) and 147 ± 14 ms (oesophagus) compared to 155 ± 17 ms (VI) and 151 ± 18 ms (oesophagus) in those maintaining sinus rhythm (NS). Left atrial diameter was 48 ± 4 mm and 44 ± 7 mm respectively (NS). The optimal parameter predicting maintenance of sinus rhythm after 6 weeks appeared to be the ratio of the lowest dominant atrial cycle length (oesophageal lead or VI) to left atrial diameter. This ratio was significantly higher in patients remaining in sinus rhythm (3.4 ± 0.6 vs. 3.1 ± 0.4 ms/mm respectively, p = 0.04). Conclusion: In this study neither an index of atrial refractory period nor left atrial diameter alone were predictors of AF recurrence within the 6 weeks of follow-up. The ratio of the two (combining electrophysiological and anatomical measurements) only slightly improve the identification of patients at high risk of recurrence of persistent AF. Consequently, other ways to asses electrical remodeling and / or other variables besides electrical remodeling are involved in determining the outcome following cardioversion. © 2006 Meurling et al; licensee BioMed Central Ltd.

引用

页数：9

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