title: Predictive value of atrial electromechanical delay for atrial fibrillation recurrence.
abstract: BACKGROUND
  We investigated the predictive value of atrial electromechanical delay (AEMD) for recurrence of atrial fibrillation (AF) at 1-month after cardioversion.
  
  
  METHODS
  Seventy-seven patients with persistent AF were evaluated and finally 50 patients (12 men, 38 women) were included. All patients underwent transthoracic electrical DC cardioversion under amiodarone treatment. AEMD was measured as the time interval from the onset of the P wave on electrogram (ECG) to the beginning of late diastolic wave (Am) from the ventricular annulus and atrial walls on tissue Doppler imaging, in the apical 4-chamber view 24 h after cardiversion. P wave maximum-duration (Pmax), P wave minimum-duration (Pmin) and P wave dispersion-duration (Pdis) were calculated on the 12-lead ECG at 24-h postcardioversion. We followed the heart rate and rhythm by 12-lead ECG at 24-h, 1-week and 1-month.
  
  
  RESULTS
  At 1-month follow-up after cardioversion, 28 (56%) patients were in sinus rhythm (SR), whereas 22 (44%) patients reverted to AF. The AEMD durations were longer in AF group than SR group (p < 0.001) and were signifi cantly correlated with Pmax and Pdis (p < 0.001 for both). For AF recurrence; duration of AF, left atrial (LA) diameter, maximum LA volume index, mitral A velocity and LA lateral AEMD were significant parameters in univariate-analysis, however LA lateral AEMD was the only significant parameter in multivariate-analysis (OR: 1.46; 95% CI 1.02-2.11; p = 0.03).
  
  
  CONCLUSIONS
  Our results suggest that AEMD is associated with an increased risk of recurrence of AF within 1-month. These data may have implications for the identification of patients who are most likely to experience substantial benefit from cardiversion therapy for AF.
authors: Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey. hasanari03@yahoo.com.
authors: Hasan
authors: H
authors: Ari
authors: Selma
authors: S
authors: Ari
authors: Mehmet
authors: M
authors: Akkaya
authors: Cihan
authors: C
authors: Aydin
authors: Nadir
authors: N
authors: Emlek
authors: O Yaşar
authors: OY
authors: Sarigül
authors: Seçkin
authors: S
authors: Çetinkaya
authors: Tahsin
authors: T
authors: Bozat
authors: Muhammet
authors: M
authors: Şentürk
authors: Kemal
authors: K
authors: Karaağaç
authors: Mehmet
authors: M
authors: Melek
authors: Mustafa
authors: M
authors: Yilmaz
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016279:Atrial Function, Left / Q000187:drug effects*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone