title: The predictive value of transthoracic echocardiographic variables for sinus rhythm maintenance after electrical cardioversion of atrial fibrillation. Results from the CAPRAF study, a prospective, randomized, placebo-controlled study.
abstract: OBJECTIVE
  The recurrence rate of atrial fibrillation after electrical cardioversion is disappointingly high. The aim of the present study was to prospectively investigate if standard echocardiographic variables at the day of cardioversion could predict sinus rhythm maintenance.
  
  
  METHODS
  Transthoracic echocardiographic examination was performed within 4 h after cardioversion for all the patients in the CAPRAF (Candesartan in the Prevention of Relapsing Atrial Fibrillation) study.
  
  
  RESULTS
  Cardioversion was successful for 137 patients not given specific antiarrhythmic therapy, and only 41 (30%) maintained sinus rhythm at 6-month follow-up. There were significant (p = 0.05) lower transmitral A wave velocities in the group with relapsing atrial fibrillation compared with the group with sinus rhythm at 6-month follow-up. All patients with the lowest A wave velocities had an early recurrence of atrial fibrillation. There were no differences between the groups regarding atrial dimensions or left ventricular function. The use of the angiotensin II receptor antagonist candesartan had no influence on the echocardiographic variables, nor on the recurrence rate of atrial fibrillation after cardioversion.
  
  
  CONCLUSIONS
  Transthoracic echocardiographic examination performed a short time after electrical cardioversion of atrial fibrillation showed that only A wave peak velocities were significantly predictive of sinus rhythm maintenance 6 months after the procedure.
authors.affiliation: Department of Cardiology, Ullevål University Hospital, Oslo, Norway. irgr@uus.no
authors.forename: Irene
authors.initials: I
authors.lastname: Grundvold
authors.forename: Arnljot
authors.initials: A
authors.lastname: Tveit
authors.forename: Pål
authors.initials: P
authors.lastname: Smith
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Seljeflot
authors.forename: Michael
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D018619:Echocardiography, Doppler, Pulsed; D004554:Electric Countershock; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013777:Tetrazoles / Q000627:therapeutic use
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan