Transthoracic and Transesophageal Echocardiographic Indices Predictive of Sinus Rhythm Maintenance After Cardioversion of Atrial Fibrillation: An Echocardiographic Study During Direct Current Shock

Piccoli, B. De; Rigo, Fausto; Ragazzo, M.; Zuin, Guerrino; Martino, Anna Maria; Raviele, Antonio

doi:10.1046/j.1540-8175.2001.00545.x

Cited by 12 publications

(10 citation statements)

References 7 publications

(8 reference statements)

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“…7,[9][10][11] There is also evidence suggesting that cardiac sonography may be a useful adjunct in cardiopulmonary resuscitation and in terms of predicting survival. 1,2,12 This study was conducted to determine whether cardiac sonography either alone or in combination with capnography in pulseless patients undergoing resuscitation is predictive of survival.…”

Section: Discussionmentioning

confidence: 99%

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Can Cardiac Sonography and Capnography Be Used Independently and in Combination to Predict Resuscitation Outcomes?

Salen

O’Connor

Sierzenski

et al. 2001

Academic Emergency Medicine

149

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Abstract. Objective: To measure the ability of cardiac sonography and capnography to predict survival of cardiac arrest patients in the emergency department (ED). Methods: Nonconsecutive cardiac arrest patients prospectively underwent either cardiac ultrasonography alone or in conjunction with capnography during cardiopulmonary resuscitation at two community hospital EDs with emergency medicine residency programs. Cardiac ultrasonography was carried out using the subxiphoid view during pauses for central pulse evaluation and end-tidal carbon dioxide (ETCO 2 ) levels were monitored by a mainstream capnograph. A post-resuscitation data collection form was completed by each of the participating clinicians in order to assess their impressions of the facility of performance and benefit of cardiac sonography during nontraumatic cardiac resuscitation. Results: One hundred two patients were enrolled over a 12-month period. All patients underwent cardiac sonographic evaluation, ranging from one to five scans, during the cardiac resuscitation. Fifty-three patients also had capnography measurements recorded. The presence of sonographically identified cardiac activity at any point during the resuscitation was associated with survival to hospital admission, 11/41 or 27%, in contrast to those without cardiac activity, 2/61 or 3% (p < 0.001). Higher median ETCO 2 levels, 35 torr, were associated with improved chances of survival than the median ETCO 2 levels for nonsurvivors, 13.7 torr (p < 0.01). The multivariate logistic regression model, which evaluated the combination of cardiac ultrasonography and capnography, was able to correctly classify 92.4% of the subjects; however, of the two diagnostic tests, only capnography was a significant predictor of survival. The stepwise logistic regression model, summarized by the area under the receiver operator curve of 0.9, furthermore demonstrated that capnography is an outstanding predictor of survival. Conclusions: Both the sonographic detection of cardiac activity and ETCO 2 levels higher than 16 torr were significantly associated with survival from ED resuscitation; however, logistic regression analysis demonstrated that prediction of survival using capnography was not enhanced by the addition of cardiac sonography.

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Section: Discussionmentioning

confidence: 99%

“…This finding of sonographically detected cardiac activity in ventricular fibrillation patients adds credence to two case reports in which echocardiography identified cardiac activity in subjects with ventricular fibrillation. 6,12 Salen et al…”

Section: Discussionmentioning

confidence: 99%

Can Cardiac Sonography and Capnography Be Used Independently and in Combination to Predict Resuscitation Outcomes?

Salen

O’Connor

Sierzenski

et al. 2001

Academic Emergency Medicine

149

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11][12] The relationship between the LAA-V and cardiac rhythm has been described in patients who underwent cardioversion of persistent AF. [16][17][18][19][20] If LA function was maintained at a certain level, patients were more easily kept in SR after PV-cryo. However, we sometimes encountered patients with AF in which an LA contraction could hardly be recognized.…”

Section: Relation Between the Laa-v And Long-term Resultsmentioning

confidence: 99%

“…However, our subjects included some with a long AF-D (>10 years; n=18, 18% of all patients), large LAD (=60 mm; n=28, 28% of all patients), or low LAA-V (=20 cm/s; n=38, 38% of all patients). Long-standing AF, 14,15 a large left atrium, 14,15 and low LAA-V [16][17][18][19][20] all are considered negative predictive factors for both recovery and maintenance of SR.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Left Atrial Appendage Outflow Velocity is Superior to Conventional Criteria for Predicting of Maintenance of Sinus Rhythm After Simple Cryoablation of Pulmonary Vein Orifices

Isobe

Taniguchi

Kono

et al. 2005

Circ J

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ince Haissaguerre et al reported that most atrial premature beats that initiate atrial fibrillation (AF) originate in the pulmonary veins (PV), various surgical techniques have been devised to isolated PV by incision and/or cryoablation. [1][2][3][4][5] In this context, we have used simple surgical cryoablation confined to the 4 PV orifices (PV-cryo) to eliminate chronic AF in appropriate patients undergoing cardiac surgery since 1999. We previously reported initial results in which 70% of patients showed sinus rhythm (SR) at discharge from the hospital. 6 Furthermore, we found that the duration of AF (AF-D), left atrial dimension (LAD), and the mean of peak left atrial appendage outflow velocities (LAA-V) before operation were important factors in assessing the likelihood of successful conversion from AF to SR. 6 In this study, the patients were followed up for a relatively long period of time to determine whether maintenance of SR was related to these variables as well as which of the variables was the best long-term predictor of SR. Methods PatientsWe carried out PV-cryo as part of a cardiac operation at our hospital in 101 patients with a history of chronic AF.

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“…24 Our finding that 54 (70%) of 77 patients remained in SR after discharge is a reasonable outcome despite the inclusion of patients with a long (>10 years) AF-D (n=11, 14% of all patients), large (≥65 mm) LAd (n=8, 10% of all patients), and low (≤20 cm/s) LAA-V (n=21, 27% of all patients). Long-standing AF, 26-28 a large LA [26][27][28][29][30] (especially, LAd ≥65 mm 29,30 ), and low LAA-V [31][32][33][34][35] have been shown to be negative predictive factors for both the restoration and maintenance of SR. Yuda et al reported that AF-D was significantly longer in patients with a giant LA than those without 29 and it is known that LAA-V is closely related to LA size. 35 Thus, AF-D, LAd, and LAA-V are related.…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Success in Cryoablation of the Pulmonary Veins in Patients With Chronic Atrial Fibrillation

Isobe

Taniguchi

Kono

et al. 2004

Circ J

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Transthoracic and Transesophageal Echocardiographic Indices Predictive of Sinus Rhythm Maintenance After Cardioversion of Atrial Fibrillation: An Echocardiographic Study During Direct Current Shock

Cited by 12 publications

References 7 publications

Can Cardiac Sonography and Capnography Be Used Independently and in Combination to Predict Resuscitation Outcomes?

Can Cardiac Sonography and Capnography Be Used Independently and in Combination to Predict Resuscitation Outcomes?

Left Atrial Appendage Outflow Velocity is Superior to Conventional Criteria for Predicting of Maintenance of Sinus Rhythm After Simple Cryoablation of Pulmonary Vein Orifices

Factors Predicting Success in Cryoablation of the Pulmonary Veins in Patients With Chronic Atrial Fibrillation

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