Tohoku J. Exp. Med., 2006, 208(3)

Left Atrial Appendage-Flow Velocity Predicts
Cardioversion Success in Atrial Fibrillation

BAHRI AKDENIZ, ÖZER BADAK, NEZRI BARIS, ÖZGÜR ASLAN, ÖNDER KIRIMLI, ÖZHAN GÖLDELI and SEMA GÜNERI

Department of Cardiology, Dokuz Eylül University School of Medicine, Izmir, Turkey

Restoration of sinus rhythm by electrical cardioversion is a therapeutic option in appropriately selected patients with atrial fibrillation. It is important to determine predictors of electrical cardioversion outcome in patients with atrial fibrillation. Predictive value of clinical and conventional echocardiographic parameters for predicting cardioversion outcome is limited. The role of left atrial appendage (LAA) function, which may reflect left atrial contractile function, for prediction of cardioversion outcome remains unclear. We conducted a single center prospective studyto evaluate the role of LAA function for prediction of cardioversion success in patients with atrial fibrillation. One hundred sixty three patients with atrial fibrillation underwent transthoracic and transesophageal echocardiography (TEE) before electrical cardioversion. LAA functions, including LAA peak flow velocity, LAA area and LAA ejection fraction, were examined. Cardioversion was successful in 133 patients and unsuccessful in 30 patients. Mean LAA peak emptying flow velocity was significantly higher in the patients with successful cardioversion than in those with unsuccessful cardioversion (0.34 ± 0.14 vs 0.27 ± 0.1 m/sec; p = 0.013). At multivariate logistic regression analysis, only LAA flow velocity ( > 0.28 m/sec, odds ratio = 2.8 ; p = 0.03) proved to be an independent predictor of cardioversion success. LAA area p = 0.18) and LAA ejection fraction p = 0.52) were not different between successful and unsuccessful cardioversion groups. Therefore, measurement of LAA flow velocity provides valuable information for prediction of cardioversion outcome in patients with atrial fibrillation before TEE guided cardioversion.

keywords —— cardioversion; left atrial appendage (LAA) function; atrial fibrillation

© 2006 Tohoku University Medical Press

===============================

Tohoku J. Exp. Med., 2006, 208, 243-250

Received October 3, 2005; revision accepted for publication January 6, 2006.
Correspondence: Bahri Akdeniz, M.D., Dokuz Eylül Üniversitesi, Tip Fakültesi Kardiyoloji, A.D. Inciralti 35340, Ízmir, Turkey.

e-mail:bahri.akdeniz@deu.edu.tr