Role of left atrial speckle tracking echocardiography in predicting persistent atrial fibrillation electrical cardioversion success and sinus rhythm maintenance at 6 months.

Abstract Purpose We assessed the value of left atrium speckle tracking imaging (STI) indices, and clinical and other echocardiographic parameters in persistent atrial fibrillation (AF) patients to predict the efficacy of electrical cardioversion (EC) and sinus rhythm (SR) maintenance at 6 months. Material/methods Eighty persistent AF patients planned to receive EC, underwent echocardiography including STI. After 24 h, patients with successful EC were examined to predict SR maintenance. After 6 months patients with no AF recurrence in electrocardiogram (ECG) underwent 7-day ECG to exclude silent AF. Every AF > 1 min was a recurrence. Results SR restored in 61 patients, 19 unsuccessful. Prior use of statins (68.8% vs. 42.1%, p  = 0.03) was the only factor, determined later by univariate analysis to be a significant EC success predictor (OR = 1.09, CL ± 95% 1.001–1.019, p p  = 0.04) and the dispersion of time to peak longitudinal strain (dTPLS) (86.0 ± 68.3 vs. 151.8 ± 89.6, p  = 0.03) differed significantly. The univariate analysis revealed dTPLS as a significant predictor of SR maintenance. Conclusion High EC efficacy and frequent AF recurrences were observed. The dispersion of time to the maximal longitudinal strain (LS) of left atrial segments facilitated prediction of SR maintenance. The value of 7-day ECG monitoring for detection of arrhythmia after 6 months was limited.