title: Role of left atrial speckle tracking echocardiography in predicting persistent atrial fibrillation electrical cardioversion success and sinus rhythm maintenance at 6 months.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Anika
authors.initials: A
authors.lastname: Doruchowska
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Krystian
authors.initials: K
authors.lastname: Wita
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland. Electronic address: tbochun1@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bochenek
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Szydło
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Filipecki
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Staroń
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wróbel
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Krzych
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Trusz-Gluza
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D004452:Echocardiography / Q000379:methods*; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012849:Sinoatrial Node / Q000502:physiology*
keywords: Cardioversion; Echocardiography; Speckle tracking