P1358Atrial electromechanical interval in patients with arrhythmias: is everyone the same?

Abstract

Background Atrial electromechanical delay, assessed calculating the PA-TDI interval using tissue Doppler imaging, is a known and promising determinant for atrial fibrillation recurrence prediction after pulmonary vein isolation and electrical cardioversion. Purpose To determine the relationship between atrial electromechanical delay and the presence of atrial fibrillation. Methods We prospectively enrolled patients presenting at our Unit in sinus rhythm scheduled for an arrhythmogenic substrate ablation (atrial fibrillation -AF-, supraventricular tachycardia -SVT- and premature ventricular contractions -PVC-). Demographic and echocardiographic characteristics were evaluated upon admission. Atrial electromechanical delay was inferred via the PA-TDI interval, obtained by calculating the time difference between the P wave onset and the A" wave peak on TDI recordings. Results From October 2018 to August 2019, 200 patients (60% male, mean age 58,21 ± 14,26, mean BSA 1,9 ± 0,21 m2, mean BMI 26,42 ± 6,28 kg/m2, mean EF 60,91% ± 5,43%) were admitted to our unit to undergo AF (group 1: n = 145; 72,50%), SVT or PVC ablation (group 2: n = 55; 27,5%). Compared with the control group (group 2), patients admitted for AF ablation had a larger LA size (group 1 vs group 2: mean LA area 23,21 ± 5,07 vs 16,87 ± 4,01 cm2, p < 0,001; mean indexed LA volume 46,71 ± 20,41 ml vs 32,04 ± 14,7 ml, p < 0,001; mean LAD 41,77 ± 5,66 vs 33,84 ± 6,06, p < 0,001) and a longer PA-TDI interval (lateral 148,55 ± 28,5 vs 128,57 ± 20,9, p < 0,001; medial 125,34 ± 21,02 vs 109,11 ± 21,49, p < 0,001; average 141,43 ± 27,58 vs 119,08 ± 18,63, p < 0,001). Conclusion The PA-TDI interval is a non-invasive and easily achievable echocardiographic parameter, which is demonstrated to be prolonged in patients with a history of AF in contrast with patients with other arrhythmias, as expression of atrial conduction heterogeneity. Abstract Figure. PA-TDI measurement