Recovery of left and right ventricular strain after cardioversion is inversely associated with long-term AF burden (p = 0.004 for LV-GLS; p = 0.028 for RV-FWS).
Does recovery of myocardial strain following elective cardioversion predict early AF recurrence and long-term AF burden in patients with atrial fibrillation?
Functional recovery of ventricular strain following elective cardioversion is strongly associated with long-term rhythm stability and lower AF burden.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Elective cardioversion (ECV) frequently restores sinus rhythm in patients with atrial fibrillation (AF); however, recurrence rates remain high, and reliable predictors of sustained rhythm control are limited. This study evaluated whether recovery of myocardial strain following ECV correlates with early AF recurrence and long-term AF burden, using continuous rhythm monitoring. Methods In this prospective cohort study, echocardiographic assessment—including left atrial reservoir strain (LA reservoir strain), left ventricular global longitudinal strain (LV-GLS), and right ventricular free wall strain (RV-FWS)—was performed prior to and within 3 weeks after ECV. Continuous rhythm data were collected over 12 months using implantable loop recorders. AF burden, defined as the percentage of time spent in AF, was categorized into five groups: 0%, 0–1%, 1.1–10%, 10–50%, and 50%. Early recurrence was defined as AF reappearance within 30 days post-ECV. Group comparisons were conducted using one-way ANOVA. Results A total of 46 patients were included. Significant post-ECV improvements in strain were observed in all chambers (mean ΔLA reservoir strain: +6.68 ± 7.71%, p0.001; ΔLV-GLS: –3.98 ± 3.26%, p0.001; ΔRV-FWS: –5.14 ± 5.22%, p0.001). Improvements in LV-GLS and RV-FWS were significantly associated inversely with long-term AF burden (ΔLV-GLS: p = 0.004; ΔRV-FWS: p = 0.028). LA reservoir strain changes did not differ significantly across burden categories (p = 0.147). Patients with 50% AF burden exhibited minimal or no improvement in ventricular strain (ΔLV-GLS: –0.4%; ΔRV-FWS: +1.14%). Additionally, early AF recurrence (30 days) was significantly associated with smaller improvements in all three strain parameters (ΔLV-GLS: p 0.001; ΔRV-FWS: p 0.001; ΔLA reservoir strain: p = 0.011). Conclusion Functional recovery of both the left and right ventricles following cardioversion was strongly associated with long-term rhythm stability. Although LA reservoir strain improved across all groups, it did not distinguish between AF burden outcomes. These findings suggest that ventricular strain recovery may serve as a marker of myocardial resilience and a predictor of cardioversion success.
Andel et al. (Thu,) reported a other. Recovery of left and right ventricular strain after cardioversion is inversely associated with long-term AF burden (p = 0.004 for LV-GLS; p = 0.028 for RV-FWS).