Department of Cardiology, Medical University of Silesia, Katowice, Poland.
Department of Cardiology, Medical University of Silesia, Katowice, Poland.
Adv Med Sci. 2014 Mar;59(1):120-5. doi: 10.1016/j.advms.2013.10.003. Epub 2014 Mar 24.
We assessed the value of left atrium speckle tracking imaging (STI) indices, and clinical and other echocardiographic parameters in persistent atrial fibrillation (AF) patients to predict the efficacy of electrical cardioversion (EC) and sinus rhythm (SR) maintenance at 6 months.
MATERIAL/METHODS: Eighty persistent AF patients planned to receive EC, underwent echocardiography including STI. After 24h, patients with successful EC were examined to predict SR maintenance. After 6 months patients with no AF recurrence in electrocardiogram (ECG) underwent 7-day ECG to exclude silent AF. Every AF>1 min was a recurrence.
SR restored in 61 patients, 19 unsuccessful. Prior use of statins (68.8% vs. 42.1%, p=0.03) was the only factor, determined later by univariate analysis to be a significant EC success predictor (OR=1.09, CL ± 95% 1.001-1.019, p<0.03). Both groups received similar antiarrhythmics and had similar echocardiographic parameters. After 6 months, SR was maintained in 19 patients (31.1%, Group I); AF recurrences were registered in 42 patients (68.8%, Group II). In Group I, only the mitral valve deceleration time (MVDT) 224.18 ± 88.13 vs. 181.6 ± 60.6 in Group II, p=0.04) and the dispersion of time to peak longitudinal strain (dTPLS) (86.0 ± 68.3 vs. 151.8 ± 89.6, p=0.03) differed significantly. The univariate analysis revealed dTPLS as a significant predictor of SR maintenance.
High EC efficacy and frequent AF recurrences were observed. The dispersion of time to the maximal longitudinal strain (LS) of left atrial segments facilitated prediction of SR maintenance. The value of 7-day ECG monitoring for detection of arrhythmia after 6 months was limited.
我们评估了左心房斑点追踪成像（STI）指数以及持续性心房颤动（AF）患者的临床和其他超声心动图参数在预测电复律（EC）和窦性心律（SR）维持 6 个月时的疗效中的价值。
材料/方法：计划接受 EC 的 80 例持续性 AF 患者接受超声心动图检查，包括 STI。在 24 小时后，对成功进行 EC 的患者进行检查以预测 SR 维持情况。在 6 个月后，在心电图（ECG）中没有 AF 复发的患者进行了 7 天的 ECG 检查以排除无症状 AF。任何>1 分钟的 AF 均为复发。
61 例患者恢复 SR，19 例未成功。他汀类药物的先前使用（68.8%比 42.1%，p=0.03）是唯一的因素，随后的单因素分析确定其是 EC 成功的显著预测因素（OR=1.09，CL ± 95% 1.001-1.019，p<0.03）。两组均接受了类似的抗心律失常药物治疗，且超声心动图参数相似。6 个月后，19 例患者维持 SR（31.1%，I 组）；42 例患者发生 AF 复发（68.8%，II 组）。在 I 组中，只有二尖瓣减速时间（MVDT）224.18 ± 88.13 与 II 组中的 181.6 ± 60.6 有显著差异（p=0.04），时间至峰值纵向应变的离散度（dTPLS）（86.0 ± 68.3 与 151.8 ± 89.6，p=0.03）也有显著差异。单因素分析显示 dTPLS 是 SR 维持的显著预测因子。
观察到高 EC 疗效和频繁的 AF 复发。左心房节段最大纵向应变（LS）时间的离散度有助于预测 SR 的维持。6 个月后 7 天 ECG 监测对检测心律失常的价值有限。
