• Dariusz Kosior, Marian Szulc, Radosław Piatkowski, Daniel Rabczenko, Adam Torbicki, and Grzegorz Opolski.
• Chair and Department of Cardiology, Medical University of Warsaw, Poland.
• Kardiol Pol. 2003 Aug 1; 59 (8): 128-41; commentary 141.

BackgroundLong-term maintenance of sinus rhythm (SR) after successful cardioversion (CV) of persistent atrial fibrillation (AF) carries a low risk of stroke and may avoid the risks associated with anticoagulation.AimTo determine the clinical and echocardiographic predictors of maintaining SR during one-year follow-up.MethodsThe initial study group consisted of 205 patients with persistent AF of whom 104 (33 females, 71 males, mean age 60.4+/-7.4 years) were randomised to SR restoration and maintenance. The results of transthoracic echocardiography, obtained before CV, were compared between patients who remained in SR and those in whom AF recurred during a one-year follow-up period, using the linear and logistic regression analysis.ResultsSR was present in 63.5% of patients at the end of the follow-up period. Of several analysed echocardiographic parameters, an increased left atrial area (<28 cm(2)) (p<0.02; RR 1.72, OR 1.09-2.71) and an increase in the fractional shortening of the left ventricle (range 25-40%, p<0.05, RR 1.2, OR 1.01-1.44) were significantly associated with SR maintenance during a 12-month follow-up period.ConclusionsLeft atrial area and left ventricular fractional shortening are the independent predictors of the maintenance of SR after successful CV in patients with persistent AF.

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