Tissue Doppler Imaging Analysis at Pre‐Cardioversion Time Predicts Recurrent Atrial Fibrillation: A 12‐Month Follow‐Up Study

Tissue Doppler imaging (TDI) has been extensively used in several clinical settings. We aimed to investigate whether TDI can predict recurrent atrial fibrillation (AF). Methods and Results: Seventy‐four consecutive patients (aged 62.6 ± 11.7 years) with AF (>48 hours and <6 months of duration) who underwent successful external electrical direct current cardioversion and 20 healthy individuals were enrolled. Conventional echocardiography and TDI were prospectively performed before cardioversion. Based on a cutoff point of 5.43 cm/sec for the negative systolic wave velocity (NSWV), derived by the normal controls (mean + 2 SD), patients were divided into Group I (36 patients) with a NSWV >5.43 cm/sec and Group II (38 patients) with NSWV ≤5.43 cm/sec. In Group I, 27.8% of patients were in sinus rhythm at 6 months, but had episodes of asymptomatic paroxysmal AF lasting >48 hours; all patients were in AF at 12 months. In Group II, all patients were in sinus rhythm at 12 months. However, those patients presenting with a NSWV less but near to 5 cm/sec had frequent episodes of asymptomatic paroxysmal AF lasting for <48 hours. Conclusion: One year after successful direct current cardioversion, TDI analysis at pre‐cardioversion time may be a useful marker to identify a subgroup of patients with increased risk for AF recurrence.