Left atrial appendage doppler velocity as a predictor of recurrence of atrial fibrillation after transesophageal echocardiogram guided electrical cardioversion

Abstract

Background: There is a paucity of data on average left atrial appendage emptying velocity (LAAV) measured by doppler during transesophageal echocardiogram (TEE) being able to predict the risk of AF recurrence after electrical cardioversion (ECV). Methods: Using electronic medical records from a community hospital, retrospective study was conducted after identifying all patients that received TEE-guided ECV. Data pertaining to LAAV, AF recurrence, and variables were obtained and analyzed. Results: Out of 625 patients receiving TEE-guided ECV, 94 were excluded, and 51 did not convert to sinus rhythm. 480 patients had a successful ECV; out of these, 201 (41.87%) and 243 (50.62%) had a recurrence of atrial fibrillation at the end of 1 month and 3 months, respectively. Low LAAV (<=30 cm/s) was independently associated with an increased risk of AF recurrence at the end of 1 month (aOR 2.37, 95CI 1.5–3.73; p < 0.001) and 3 months (aOR 2.51, 95CI 1.59–3.96; p < 0.001) after TEE-guided ECV. Conclusions: Low LAAV is associated with a high risk of AF recurrence. Identifying a specific subgroup of individuals at high risk of AF recurrence with the help of pre-ECV LAAV will facilitate the early institution of alternate treatment strategies and the plan for additional therapies.

Keywords

• Atrial fibrillation
• Electrical cardioversion
• Recurrence
• Left atrial appendage velocity
• Transesophageal echocardiogram