scholarly journals Clinical determinants of early spontaneous conversion to sinus rhythm in patients with atrial fibrillation

2021 ◽  
Author(s):  
N. A. H. A. Pluymaekers ◽  
E. A. M. P. Dudink ◽  
B. Weijs ◽  
K. Vernooy ◽  
D. E. J. Hartgerink ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Standard Of Care ◽  
Volume Index ◽  
Current Standard ◽  
Left Atrial Volume Index ◽  
First Onset ◽  
Spontaneous Conversion

Abstract Background The current standard of care for acute atrial fibrillation (AF) focuses primarily on immediate restoration of sinus rhythm by cardioversion, although AF often terminates spontaneously. Objective To identify determinants of early spontaneous conversion (SCV) in patients presenting at the emergency department (ED) because of AF. Methods An observational study was performed of patients who visited the ED with documented AF between July 2014 and December 2016. The clinical characteristics and demographics of patients with and without SCV were compared. Results We enrolled 943 patients (age 69 ± 12 years, 47% female). SCV occurred within 3 h of presentation in 158 patients (16.8%). Logistic regression analysis showed that duration of AF <24 h [odds ratio (OR) 7.7, 95% confidence interval (CI) 3.5–17.2, p < 0.001], left atrial volume index <42 ml/m2 (OR 1.8, 95% CI 1.2–2.8, p = 0.010), symptoms of near-collapse at presentation (OR 2.4, 95% CI 1.2–5.1, p = 0.018), a lower body mass index (BMI) (OR 0.9, 95% CI 0.91–0.99, p = 0.028), a longer QTc time during AF (OR 1.01, 95% CI 1.0–1.02, p = 0.002) and first-detected AF (OR 2.5, 95% CI 1.6–3.9, p < 0.001) were independent determinants of early SCV. Conclusion Early spontaneous conversion of acute AF occurs in almost one-sixth of admitted patients during a short initial observation in the ED. Spontaneous conversion is most likely to occur in patients with first-onset, short-duration AF episodes, lower BMI, and normal left atrial size.

Abstract 13956: Cystatin C Based Estimated Glomerular Filtration Rate is a Feasible Parameter for Incident Stroke in Patients With Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Naoto Hashimoto ◽  
Satoshi Nishiyama ◽  
Tetsu Watanabe ◽  
Masahiro Wanezaki ◽  
Gensai Yamaura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cystatin C ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Left Atrial Volume ◽  
Atrial Appendage ◽  
Volume Index ◽  
Chads2 Score ◽  
Left Atrial Volume Index ◽  
Ckd Stage

Introduction: Chronic kidney disease (CKD) is an important risk factor of stroke in patients with atrial fibrillation (AF). Since AF patients with high CHADS2 score are likely to be old and have history of TIA or stroke, there could be patients who have sarcopenia. Cystatin C based estimated glomerular filtrarion rate (eGFRcys) is less affected by age, gender and muscle mass compared to creatine based eGFR (eGFRcr). We investigated whether eGFRcys is more closely associated with incident stroke in AF patients compared to eGFRcr. Methods: We performed transthoracic and transesophageal echocardiography and measured eGFRcys and eGFRcr in 349 patients with paroxysmal AF and chronic AF (256 males, 64.4 ± 11.7 years). We excluded those who had severe valvular heart disease and end stage renal desease. There were 42 patients with stroke history. Results: eGFRcys showed better correlation with left atrial volume index, levels of brain natriuretic peptide, von Willebrand factor, and left atrial appendage emptying flow velocity, than eGFRcr. eGFRcys was decreased with increading CHADS2 and CHA2DS2VASc score. Patients with left atrial appendage and/or spontaneous echo contrast had a significantly lower eGFRcys compared to those without. The proportion of patients with stroke was increased with advancing CKD stage in eGFRcys. Although eGFRcys and eGFRcr were associated with stroke in logistic regression analysis, eGFRcys but not eGFRcr was an independent predictor for stroke after adjustment for CHADS2 score. Conclusion: eGFRcys is a feasible parameter for incident stroke in AF patients.

scholarly journals ASSOCIATION OF ATRIAL FIBRILLATION AND LEFT ATRIAL VOLUME INDEX WITH MORTALITY IN PATIENTS WITH COVID-19 PNEUMONIA

2020 ◽  
Author(s):  
Antonello D Andrea ◽  
Vincenzo Russo ◽  
Gianluca Manzo ◽  
Valerio Giordano ◽  
Marco Di Maio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

Abstract 15589: Relationship Between Left Atrial Volume Index and Left Atrial Appendage Function in Patients With Non-Valvular Atrial Fibrillation and a Cha2ds2-vasc Score of 0-1

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Keisuke Minami ◽  
Masaki Izumo ◽  
Kihei Yoneyama ◽  
Yoshihiro J Akashi
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Low Risk ◽  
Low Flow ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Flow Group

Introduction: The management of patients with non-valvular atrial fibrillation (NVAF) and low CHA2DS2-VASc scores remains controversial. Left atrial appendage (LAA) function is a known risk factor for embolisms. Hypothesis: In this study, we aimed to investigate the value of the relationship between transthoracic echocardiography (TTE) parameters and LAA function in low-risk (CHA2DS2-VASc score, 0-1) patients with NVAF. Methods: This retrospective study included 370 consecutive patients with NVAF who underwent both TTE and transesophageal echocardiography (TEE). The LAA emptying flow velocity was assessed using TEE. We established that an LAA emptying flow velocity of <25 cm/s was associated with a high risk of thrombus formation. Results: Of the 370 patients, 146 (40%) had a CHA2DS2-VASc score of 0-1. These patients with low-risk NVAF were further stratified into the low-flow (LAA emptying flow velocity < 25 cm/s, n = 19) and normal-flow (LAA emptying flow velocity ≥ 25 cm/s, n = 127) groups according to LAA function (atrial fibrillation during TEE: n = 63). The age, gender, CHA2DS2-VASc score, and left ventricular ejection fraction did not differ between the two groups. The low-flow group had a significantly greater left atrial volume index (LAVI) than the normal-flow group (51.6 ± 19.8 vs. 32.3 ± 12.1 ml/m2, p < 0.01). A LAVI of 37.8 ml/m2 predicted a LAA emptying flow velocity of <25 cm/s with a sensitivity of 73% and specificity of 83% among patients with low-risk atrial fibrillation (area under the curve, 0.818, p < 0.001, Figure). Conclusions: Approximately 13% of patients with NVAF and CHA2DS2-VASc score of 0-1 had reduced LAA emptying flow velocity as well as left atrial enlargement. The use of LAVI may improve the current embolism risk stratification system among these patients.

Sign in / Sign up

Export Citation Format

Share Document