Left Atrial Electromechanical Conduction Time Can Predict Six-Month Maintenance of Sinus Rhythm After Electrical Cardioversion in Persistent Atrial Fibrillation by Doppler Tissue Echocardiography

Park, Seong‐Mi; Kim, Yong Hyun; Choi, Jong Il; Pak, Hui Nam; Kim, Young Hoon; Shim, Wan Joo

doi:10.1016/j.echo.2009.12.019

Cited by 53 publications

(72 citation statements)

References 28 publications

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“…Merckx et al [15] demonstrated that tissue Doppler echocardiography can be used to measure total duration of atrial electrical activation which is valuable to detect patients with risk of AF development. In another study, left atrial electromechanical conduction time was found to be significantly prolonged in patients with recurring AF after electrical cardioversion, and it has been stated that electromechanical conduction time parameters evaluated by tissue Doppler echocardiography can be used as indicators of atrial conduction time for prediction of sinus rhythm maintenance [16]. EF -ejection fraction; FS -fractional shortening; IVRT -isovolumic relaxation time; LVEDD -left ventricular enddiastolic diameter; LVESD -left ventricular endsystolic diameter; Pmax durationduration of the longest P wave; Pmin duration -duration of the shortest P wave The relationship between left atrial size and AF has been shown in previous studies [17,18].…”

Section: Discussionmentioning

confidence: 99%

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Deniz

Şahiner²,

Aytemir³

et al. 2012

Cardiol J

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Section: Discussionmentioning

confidence: 99%

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Deniz

Şahiner²,

Aytemir³

et al. 2012

Cardiol J

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“…Similarly, a newly proposed echo-Doppler-derived LA electromechanical conduction time (EMT), reflecting the ability of atrial tissue to propagate electric activation, has been reported to be predictive of recurrent or new-onset AF, [19][20][21] but it lacks validity in a broader spectrum of patient populations, as well as a comprehensive comparative evaluation with other atrial indices. Accordingly, we sought in this study to investigate factors associated with a first episode of AF in patients undergoing dual chamber pacemaker implantation, with special focus on LA volume, LA strain, and EMT measurement.…”

Section: Kosmala Et Al Atrial Fibrillation With Cardiac Pacingmentioning

confidence: 99%

Incremental Value of Left Atrial Structural and Functional Characteristics for Prediction of Atrial Fibrillation in Patients Receiving Cardiac Pacing

Kosmala

Saito

Kaye

et al. 2015

Circ: Cardiovascular Imaging

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A trial fibrillation (AF) is a known complication of right ventricular (RV) pacing, 1,2 occurring in 3% to 15% per year, being more common in older subjects and in the absence of AV synchrony. 3,4 As AF poses a significant medical and economic burden, 5 appropriate risk prediction for AF might be helpful in improving the cost-effectiveness of diagnostic and therapeutic measures directed toward preventing this arrhythmia and its well-known consequences.6 However, risk factors for AF are multiple and many of them remain ill-defined, 7 so additional risk profiling to stratify the risk of pacemaker-related AF may enable a more personalized approach to decision-making.Left atrial (LA) remodeling, including changes in LA size, function, and electric properties, provides a substrate for AF. [8][9][10] Despite the contribution of LA enlargement to the occurrence and progression of AF, 10-13 the assessment of LA volume (LAV)-the most robust marker of LA sizeis not recommended for routine use in risk evaluation, because its predictive value seems lower than expected. 14,15 LA functional evaluation might improve the identification of patients at risk for AF. Recently, LA strain has been Background-Better prediction of cardiac pacing patients at risk of atrial fibrillation (AF) would enable more effective prophylaxis. We sought whether left atrial (LA) electromechanical conduction time (EMT) and myocardial mechanics were associated with incident AF in patients undergoing dual chamber pacemaker implantation, independent of left atrial volume (LAV). Methods and Results-Clinical data were obtained prospectively in 146 enrollees (73±10 years) undergoing dual chamber pacemaker implantation in the Protect-Pace study. Echocardiograms and 2-dimensional strain analysis were obtained post implantation and at 2 years. Complete ascertainment of AF during follow-up was identified from interrogation of permanent pacemakers. Cox regression was used to identify correlates of AF. Incident AF (n=29, 20%) was associated with higher systolic blood pressure (P=0.01), lower left ventricular ejection fraction (P=0.03), lower LA strain at atrial contraction (LASac; P<0.001), higher LAV (P<0.003), and longer septal electromechanical conduction time (P<0.01).The associations of LAV and LASac with incident AF were independent of age, sex, systolic blood pressure, and left ventricular size and function. However, the combination of the 3 strongest predictors showed LASac (P=0.02) and systolic blood pressure (P=0.01) were independently associated with incident AF, but LAV was not (P=0.07). Using the optimal cut points from receiver operator characteristic curves (62 mL for LAV and 8.6% for LASac), we demonstrated that a significantly greater rate of AF was associated with both lower LASac at higher LAV and with lower LASac at lower LAV. Conclusions-The risk of AF in patients receiving dual chamber pacing is independently associated with LA size and function, not left ventricular structural and functional characteristics or right ventricular lead locatio...

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“…Correlation of P-wave dispersion and inter-atrial dyssynchrony with other parameters. Continuous data are expressed as means ± standard deviation; IVS -interventricular septum; LA -left atrium; LV -left ventricular; LAVleft atrial volume; LAV preA -left atrial volume before atrial contraction; PA' -time interval from the onset of the P wave on surface ECG to the peak of the late diastolic wave; RA -right atrium wall PA' estimates total atrial activation time [20] and has been shown to predict maintenance of SR after cardioversion in patients with persistant AF [21]. In the present study, PWD was related only to the lateral LA wall PA', thus not to intra-and inter-atrial dyssynchrony, in patients with HCM.…”

Section: Interaction Between Pwd and Atrial Dyssynchronymentioning

confidence: 99%

Relationships between P wave dispersion, atrial electromechanical delay, left atrial remodeling, and NT-proBNP levels, in patients with hypertrophic cardiomyopathy

et al. 2015

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Background: We evaluated the associations among the well-known atrial fibrillation (AF) predictors including P-wave dispersion (PWD), intra-and inter-atrial electromechanical dyssynchrony (EMD), left atrial (LA) phasic functions, and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels, in patients with hypertrophic cardiomyopathy (HCM p = 0.001), p = 0.03), p = 0.006), but not, however, to LAAEFr (p = 0.4). The plasma NT-proBNP levels of patients were not correlated with either (Cardiol J 2015; 22, 1: 94-100)

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Left Atrial Electromechanical Conduction Time Can Predict Six-Month Maintenance of Sinus Rhythm After Electrical Cardioversion in Persistent Atrial Fibrillation by Doppler Tissue Echocardiography

Cited by 53 publications

References 28 publications

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Incremental Value of Left Atrial Structural and Functional Characteristics for Prediction of Atrial Fibrillation in Patients Receiving Cardiac Pacing

Relationships between P wave dispersion, atrial electromechanical delay, left atrial remodeling, and NT-proBNP levels, in patients with hypertrophic cardiomyopathy

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