Echocardiographic Evaluation of Atrial Remodelling for the Prognosis of Maintaining Sinus Rhythm after Electrical Cardioversion in Patients with Atrial Fibrillation

Figures

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  Figure 1. Left atrial fibrillatory contraction flow (Afc). Pulsed-wave Doppler of mitral filling in the apical four-chamber projection during atrial fibrillation. Velocity time integral (VTI) and AFc velocity measurement. AFc VTI 3.8 cm. AFc V 21 cm/s.

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  Figure 2. Left atrial wall motion velocity (LAWMV). LAWMV 5 cm/s. Pulsed-wave tissue Doppler in the apical four-chamber projection during atrial fibrillation.

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  Figure 3. Left atrial appendage wall motion velocity (LAAWMV). LAAWMV 18 cm/s. Pulsed-wave tissue Doppler in two-chamber 60–90° projection in transoesophageal echocardiography during atrial fibrillation.

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  Figure 4. Left atrial strain. pLASr 22%, peak left atrial stain measured during the reservoir phase; pLASct 11%, peak left atrial stain measured during the contractile phase. The measurements are the average of the 6 assessed left atrial wall segments. The measurement was made in the apical four-chamber projection during sinus rhythm.

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  Figure 5. Left atrial strain rate. pLASRr 1.3 s−1 peak left atrial strain rate measured during the reservoir phase. pLASRcd −1.5 s−1, peak left atrial strain rate measured during the conduit phase. pLASRct −1.9 s−1, peak left atrial strain rate measured during the contractile phase. The measurements are the average of the 6 assessed left atrial wall segments. The measurement was made in the apical two-chamber projection during sinus rhythm.

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  Figure 6. Left atrial wall dyskinesis. Stretching of one of the left atrial wall segments during the contractile phase. The phenomenon of left atrial wall dyskinesia is assessed during pLASRct; in the contractile phase, all segments of the left atrial wall should contract, while when dyskinesia occurs, one or several segments expand. The measurement was made in the apical four-chamber projection during sinus rhythm.

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  Figure 7. Total atrial conduction time (TACT). PA-TDI 160 ms. PA-TDI is the time interval between the onset of the P wave in electrocardiogram in lead I or II and the peak of the a’ wave on the atrial tissue Doppler velocity curve from the lateral left atrial wall. Pulsed-wave tissue Doppler of mitral annulus velocity in the apical four-chamber projection during sinus rhythm. a’, late lateral mitral annulus velocity; e’, early lateral mitral annulus velocity; s’, systolic mitral annulus velocity.