Author + information
- Dae Sung Lee,
- Yong Hyun Park,
- Yeon Seong Kim,
- Tae Hyun Kim,
- Soo Yong Lee,
- Min Ku Chon,
- Sang Hyun Lee,
- Ki Won Hwang,
- Jeong Su Kim,
- June Hong Kim and
- Kook Jin Chun
Background: The atrial fibrillation cycle length (AFCL) measured by electrophysiologic study is well known parameter for the maintenance of sinus rhythm after DC cardioversion (DCCV) or ablation therapy. The aim of this study was to test whether a AFCL measured by transesophageal echocardiography (AFCLTEE) could predict the outcome after DCCV.
Methods: In 100 consecutive patients with non-valvular AF, TEE was performed within 6 hours before DCCV. The AFCLTEE was measured by averaging 10 sequential peak to peak intervals of atrial fibrillary waves seen in the pulsed wave Doppler image on the left atrial appendage (Figure, Right). The primary endpoint was AF free survival rate at 6 months after DCCV.
Results: 49 maintained sinus rhythm at 6 months after DCCV, who had significantly longer AFCLTEE than that in patients who had AF recurrence (154±36 ms vs. 107±20 ms, p<0.001). On the basis of the AFCL cut-off value (125 ms) obtained by ROC curve, patients were divided into long (n=50, 159±31 ms) and short AFCLTEE (n=50, 102±14 ms) groups. AF free survival rate at 6 months were significantly higher in the long AFCLTEE group (86% vs. 12%, p<0.001; Figure, Left). In the multiple Cox regression analysis, the long AFCLTEE group was associated with significantly lower adjusted risk of AF recurrence at 6 months after DCCV (HR 0.07, 95% CI 0.03 to 0.16, p<0.001).
Conclusions: The longer AFCLTEE before DCCV was strongly associated with the lower AF recurrence after DCCV and might be an independent predictor for AF-free survival.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Basic 3
Abstract Category: 4. Arrhythmias and Clinical EP: Basic
Presentation Number: 1191-112
- 2017 American College of Cardiology Foundation