Evaluation of Atrial Electromechanical Delay to Predict Atrial Fibrillation in Hemodialysis Patients

Abstract

Background and objective: Prevalence of atrial fibrillation is higher in hemodialysis patients as compared to the general population. Atrial electromechanical delay is known as a significant predictor of atrial fibrillation. In this study, we aimed to reveal the relationship between atrial electromechanical delay and attacks of atrial fibrillation. Materials and methods: The study included 77 hemodialysis patients over 18 years of age giving written consent to participate in the study. The patients were divided into two groups based on the results of 24-h Holter Electrocardiogram (Holter ECG) as the ones having attacks of atrial fibrillation and the others without any attack of atrial fibrillation. Standard echocardiographic measurements were taken from all patients. Additionally, atrial conduction times were measured by tissue Doppler technique and atrial electromechanical delays were calculated. Results: Intra- and interatrial electromechanical delay were found as significantly lengthened in the group of patients with attacks of atrial fibrillation (p = 0.03 and p < 0.001 respectively). The optimal cut-off time for interatrial electromechanical delay to predict atrial fibrillation was >21 ms with a specificity of 79.3% and a sensitivity of 73.7% (area under the curve 0.820; 95% confidence interval (CI), 0.716–0.898). In the multivariate logistic regression model, interatrial electromechanical delay (odds ratio = 1.230; 95% CI, 1.104–1.370; p < 0.001) and hypertension (odds ratio = 4.525; 95% CI, 1.042–19.651; p = 0.044) were also associated with atrial fibrillation after adjustment for variables found to be statistically significant in univariate analysis and correlated with interatrial electromechanical delay. Conclusions: Interatrial electromechanical delay is independently related with the attacks of atrial fibrillation detected on Holter ECG records in hemodialysis patients.

Preoperative Electrocardiogram and Perioperative Methods for Predicting New-Onset Atrial Fibrillation During Lung Surgery

“…This electrical remodeling might be the etiology of AF. 30 QRS duration was an independent predictor of NOAF in this study, which was in concordance with previous findings. 31,32 The right and left atrium are composed of overlapping myocytes in the form of myocardial fibers that come together and create the atrial walls.…”

Evaluation of Atrial Electromechanical Delay in Children with Obesity

“…EMD is one of them and is defined as the time between the occurrence of force in the myocardium and the onset of electrical activity. The EMD, which is easily obtainable by tissue Doppler imaging (TDI), also indicates atrial conduction heterogeneity [20]. It is well known that increased atrial EMD in TDI is an indicator of supra-ventricular tachycardia development [21].…”

Effects of metformin on epicardial adipose tissue and atrial electromechanical delay of obese children with insulin resistance

“…It has been demonstrated that atrial electromechanical delay predicts arrhythmias in studies conducted with adults and children. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Although its mechanism has not been completely understood in obesity, pro-inflammatory cytokines like interleukin-1, interleukin-6 and tumour necrosis factor-α which are secreted from visceral and epicardial adipose tissue may cause atrial electromechanical delay by causing inflammation in atrial tissue. 29 A decrease in visceral and epicardial adipose tissue may also cause a decrease in electromechanical delay by further reducing existing inflammation.…”

“…The difference between PA septum and PA tricuspid (PA septum − PA tricuspid) was identified as an intra-atrial electromechanical delay, while the difference between PA lateral and PA tricuspid (PA lateral − PA tricuspid) was identified as an inter-atrial electromechanical delay. 17…”