Elective electrical cardioversion significantly improved right ventricular free wall strain from −13.0% to −18.1% (p < 0.001) in patients with atrial fibrillation.
Does elective electrical cardioversion improve right ventricular free wall strain in patients with symptomatic persistent atrial fibrillation?
Restoration of sinus rhythm via elective electrical cardioversion significantly improves right ventricular free wall strain and systolic function parameters at 10 days.
Absolute Event Rate: 0% vs 0%
Abstract Background Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with adverse cardiovascular outcomes. Elective electrical cardioversion (ECV) is a standard therapeutic strategy to restore sinus rhythm in patients with persistent AF. However, its impact on right ventricular (RV) physiology—particularly right ventricular free wall strain (RV-FWS)—remains poorly understood. This study aimed to evaluate changes in RV-FWS before and after elective ECV in patients with AF. Methods We conducted a prospective cohort study involving 46 patients with symptomatic persistent AF scheduled for elective ECV. RV-FWS was assessed using speckle-tracking echocardiography both prior to and 10 days after ECV, allowing time for post-procedural myocardial stunning to resolve. Strain measurements were compared pre- and post-procedure, and changes were analyzed for associations with baseline clinical variables, including heart rate, right and left atrial dimensions, and right and left ventricular size. Results RV strain measurement before and after ECV was feasible in 44 of the 46 patients (95.6%). Mean RV-FWS significantly improved post-ECV (−13.0 ± 4.2% vs. −18.1 ± 5.1%, p 0.001). Similarly, RV global strain (11.1 ± 3.0% vs. 15.9 ± 4.6%, p 0.001) and tricuspid annular plane systolic excursion (TAPSE) (1.5 ± 0.42 cm vs. 1.9 ± 0.49 cm, p 0.001) increased significantly. No significant changes were observed in right atrial area, RV basal diameter, left atrial volume, LV volume, or the degree of tricuspid regurgitation. The change in RV-FWS was not significantly associated with changes in heart rate (p = 0.197). Conclusions Elective electrical cardioversion in patients with atrial fibrillation is associated with significant improvements in right ventricular free wall strain, global strain, and TAPSE. These findings suggest that restoration of sinus rhythm may probably have a beneficial effect on right ventricular function. Further studies are warranted to investigate the clinical implications of these changes, particularly regarding long-term cardiovascular outcomes.Figure 1
Andel et al. (Thu,) reported a other. Elective electrical cardioversion significantly improved right ventricular free wall strain from −13.0% to −18.1% (p < 0.001) in patients with atrial fibrillation.