Prolonged atrial activation time as determined by tissue Doppler echocardiography is associated with recurrence of atrial fibrillation after a successful cardioversion

Background: Atrial Fibrillation (AF) is a very common arrhythmia. Initial therapy for AF is often directed towards restoration of sinus rhythm (SR) by means of electrical cardioversion (ECV). Recurrence of AF after ECV is not uncommon. Multivariate analyses have demonstrated that age, arrhythmia duration, atrial size, and ejection fraction are all factors related to recurrences of AF. Recently we validated a new echocardiographic technique using tissue Doppler imaging (TDI) for determination of the total atrial activation time. In the present study we evaluated the value of this new technique in relation to the known predictors for prediction of recurrent AF after successful ECV.