title: Total atrial conduction time assessed by tissue doppler imaging (PA-TDI Interval) to predict early recurrence of persistent atrial fibrillation after successful electrical cardioversion.
abstract: BACKGROUND
  The aim of this study was to investigate whether total atrial conduction time (TACT) assessed via tissue Doppler imaging (PA-TDI interval) can identify patients with early recurrent atrial fibrillation (ERAF) after successful direct-current electrical cardioversion (CV) of persistent atrial fibrillation (persPAF).
  
  
  RESULTS
  A total of 54 patients without antiarrhythmic drug medication (mean ± SD: 66 ± 10.4 years; 33% women) with persPAF and successful CV were enrolled between May 2012 and May 2013. TACT was measured 6 hours after successful CV in the left atrium by tissue Doppler imaging (PA-TDI interval). ERAF was determined via Holter-electrocardiogram over a period of 7 days after CV. Receiver opearting characteristic analysis was used to determine an optimal cutoff value of PA-TDI interval for prognosis of ERAF. Based on this result, recurrence-free survival was assessed with Mantel-Haenszel's log-rank test. ERAF occurred in 23 patients (43%). PA-TDI interval was longer in patients with ERAF compared to those who maintained sinus rhythm (mean ± SD: 163.5 ± 11.1 vs 132.3 ± 11.2 milliseconds; P < 0.00001). At the cutoff value of 152 milliseconds, PA-TDI interval sensitivity and specificity related to ERAF were 87% and 100%, respectively.
  
  
  CONCLUSIONS
  Measuring PA-TDI interval may help to predict ERAF after successful CV in patients with persAF.
authors.affiliation: Divisions of Cardiology and Angiology.
authors.forename: Patrick
authors.initials: P
authors.lastname: Müller
authors.forename: Fabian
authors.initials: F
authors.lastname: Schiedat
authors.forename: Anna
authors.initials: A
authors.lastname: Bialek
authors.forename: Leif
authors.initials: L
authors.lastname: Bösche
authors.forename: Aydan
authors.initials: A
authors.lastname: Ewers
authors.forename: Kaffer
authors.initials: K
authors.lastname: Kara
authors.forename: Johannes W
authors.initials: JW
authors.lastname: Dietrich
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000517:prevention & control*; D002908:Chronic Disease; D015150:Echocardiography, Doppler / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004554:Electric Countershock / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: PA-TDI interval; TEE cardioversion; atrial fibrillation; electrical cardioversion; total atrial conduction time