Abstract 13506: Three-Dimensional Transoesophageal Echocardiography Characterization of Left Atrial Appendage Dimensions in Patients With Spontaneous Cardioversion of Atrial Fibrillation

Abstract

Introduction: Few studies have described the clinical profile and natural history of patients with spontaneous cardioversion (SpCV) in atrial fibrillation (AF). Hypothesis: We hypothesized that patients with SpCV have a distinct morphological pattern in AF. Methods: We prospectively evaluated 262 patients hospitalized for AF using two-dimensional (2D) transthoracic (TTE) and three-dimensional (3D) transoesophageal echocardiography (TEE). 3D parameters were off-line analysed using Tomtec software (4D Cardio-View, Philips). Patients were divided into two groups according to the cardiac rhythm within 24 hours after admission: spontaneous cardioversion (SpCV group, 59 patients) and non-spontaneous cardioversion (noSpCV group, 203 patients). Results: Mean age of the population was 66±12 years and 166 (63%) patients were male. SpCV group had in comparison with noSpCV group lower CRP levels (respectively 3.3(3-5.5) versus 4(3-10) mg/L, p=0.0394), lower BNP levels (151(67-200) versus 269(129-424) pg/mL, p<0.001) and lower HBA1c levels (5.5(5.3-5.7) versus 5.9(5.6-6.3) %, p<0.0001). Using 2D TTE, SpCV group had in comparison with noSpCV group lower indexed left atrial end-systolic volume, lower indexed right atrial end-systolic volume, lower E velocity, and higher left ventricle ejection fraction (Table 1). Based on 2D and 3D TEE, SpCv group had in comparison with noSpCV group higher LAA emptying flow velocity and higher LAA filling flow velocity, lower 3D end-systolic and end-diastolic LAA volumes (both non-indexed and indexed) and lower 3D LAA ostium in comparison with noSpCV group (Table 1). Conclusions: Although SpCv of AF is a frequent situation incompletely studied, clinical and echocardiographic characteristics could be described. Further investigations are needed to determine the impact of such abnormalities on the prognosis in the SpCV group.