Transthoracic echocardiography parameter LAVI/a' <2.3 effectively ruled out paroxysmal atrial fibrillation in patients with cerebral ischemia, with 92% sensitivity and 98% negative predictive value.
Cohort (n=193)
Does transthoracic echocardiography (specifically LAVI/a') predict paroxysmal atrial fibrillation in patients with cerebral ischemia presenting in sinus rhythm?
An echocardiographic LAVI/a' ratio of <2.3 provides a high negative predictive value (98%) to effectively rule out paroxysmal atrial fibrillation in patients presenting with cerebral ischemia in sinus rhythm.
Effect estimate: AUC 0.813 (95% CI 0.738-0.889)
BACKGROUND AND PURPOSE: We assessed whether echocardiography can predict paroxysmal atrial fibrillation (PAF) in patients with cerebral ischemia presenting in sinus rhythm. METHODS: Within the prospective Find-AF cohort, 193 consecutive patients with cerebral ischemia and sinus rhythm on presentation had evaluation of echocardiographic parameters of left atrial size and function. PAF was diagnosed by 7-day Holter monitoring. RESULTS: In 26 patients with PAF, late diastolic Doppler (A) and tissue Doppler (a') velocities were lower whereas left atrial diameter, left atrial volume index (LAVI), LAVI/A, and LAVI/a' were larger (P<0.05 for all) than they were in 167 patients without PAF. In multivariate models A, a', LAVI/A, and LAVI/a' predicted the presence of PAF. Area under the receiver operating characteristic curve to diagnose PAF was highest for LAVI/a' (0.813 0.738; 0.889). A previously suggested cut-off of LAVI/a'<2.3 had 92% sensitivity, 55.8% specificity, and 98% negative predictive value for PAF. CONCLUSIONS: LAVI/a'<2.3 can effectively rule out PAF in patients with cerebral ischemia.
Stahrenberg et al. (Fri,) conducted a cohort in Cerebral ischemia presenting in sinus rhythm (n=193). Transthoracic echocardiography (LAVI/a') was evaluated on Diagnosis of paroxysmal atrial fibrillation (AUC 0.813, 95% CI 0.738-0.889). Transthoracic echocardiography parameter LAVI/a' <2.3 effectively ruled out paroxysmal atrial fibrillation in patients with cerebral ischemia, with 92% sensitivity and 98% negative predictive value.