Wałek Paweł, Roskal-Wałek Joanna, Dłubis Patryk, Wożakowska-Kapłon Beata
Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland.
1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland.
J Clin Med. 2023 Aug 7;12(15):5158. doi: 10.3390/jcm12155158.
Atrial fibrillation (AF) is the most common atrial tachyarrhythmia. One of the methods of AF treatment is direct current cardioversion (DCCV), but in the long-term follow-up we observe quite a high percentage of AF recurrences after this procedure. In order to assess the prognosis of DCCV effectiveness, we use clinical, biochemical and echocardiographic parameters. The objective of this review is to systematise the current knowledge on echocardiographic measurements in patients with persistent AF used to assess the progress of remodelling of the atrial wall, which affects the likelihood of maintaining sinus rhythm after DCCV. In this article, echocardiographic parameters for the evaluation of remodelling of the atrial wall are divided into groups referring to structural, mechanical, and electrical remodelling, as well as parameters for the evaluation of left ventricular filling pressure. The article aims to draw attention to the clinical value of echocardiographic measurements, which is the selection of patients who will maintain sinus rhythm after DCCV in the long-term follow-up, which will allow to avoid unnecessary risks associated with the procedure and enable the selection of the appropriate treatment strategy.
心房颤动（AF）是最常见的房性快速心律失常。房颤治疗方法之一是直流电复律（DCCV），但在长期随访中我们观察到该手术后房颤复发率相当高。为了评估直流电复律有效性的预后，我们使用临床、生化和超声心动图参数。本综述的目的是系统整理目前关于持续性房颤患者超声心动图测量的知识，这些测量用于评估心房壁重塑的进展，而心房壁重塑会影响直流电复律后维持窦性心律的可能性。在本文中，用于评估心房壁重塑的超声心动图参数分为涉及结构重塑、机械重塑和电重塑的组，以及用于评估左心室充盈压的参数。本文旨在提请注意超声心动图测量的临床价值，即在长期随访中选择能够在直流电复律后维持窦性心律的患者，这将有助于避免与该手术相关的不必要风险，并能够选择合适的治疗策略。
