The Role of the Atrial Electromechanical Delay in Predicting Atrial Fibrillation in Myotonic Dystrophy Type 1 Patients

Abstract

Our results showed that the echocardiographic atrial electromechanical delay indices (intraleft and inter-AEMD) were significantly increased in DM1 subjects with normal cardiac function. Intraleft and inter-AEMD represent noninvasive, inexpensive, useful and simple parameters to assess the AF risk in DM1 patients.

Which Is the True Epidemiology of Atrial Fibrillation in Myotonic Dystrophy Type 1 Patients?

“…3 We recently observed an atrial fibrillation (AF) prevalence of 30% in the DM1 population who underwent long-period (30 days) external loop recorder (ELR) monitoring performed every 6 months during a 4-year followup. 4 These data confirmed the high prevalence of atrial high-rate episodes detected by pacemaker (PM) diagnostics in DM1 patients who underwent device implantation and considered a surrogate of atrial fibrillation. 5 doi: 10.1111/pace.12970…”

“…Atrial fibrillation is a common finding on 12‐lead ECG or 24‐hour Holter monitoring, often asymptomatic, with a prevalence up to 17% in DM1 population and it is associated with a significant risk of death in association with the DM1 patients’ age . We recently observed an atrial fibrillation (AF) prevalence of 30% in the DM1 population who underwent long‐period (30 days) external loop recorder (ELR) monitoring performed every 6 months during a 4‐year follow‐up . These data confirmed the high prevalence of atrial high‐rate episodes detected by pacemaker (PM) diagnostics in DM1 patients who underwent device implantation and considered a surrogate of atrial fibrillation…”

“…Noninvasive electrocardiographic and echocardiographic markers are useful in clinical practice to predict arrhythmias in some clinical conditions, [6][7][8][9][10] including muscular dystrophy. [11][12][13][14][15] In particular, we previously showed that the electrocardiographic (P-wave duration and dispersion) and echocardiographic noninvasive indicators of atrial conduction heterogeneity (intraleft and interatrial electromechanical delay indices) were significantly increased in DM1 patients with AF compared to those with no arrhythmias and were independent predictors of AF onset. 4,14 Therefore, we suggest the authors to include in their future analysis a detailed evaluation about the clinical utility of these electrocardiographic and echocardiographic parameters for predicting supraventricular and ventricular arrhythmias in DM1 population.…”

“…For the high supraventricular arrhythmias risk and its consequences, the early identification of DM1 patients with atrial fibrillation risk is of pivotal importance for the optimization of the clinical follow‐up and medical therapy. Noninvasive electrocardiographic and echocardiographic markers are useful in clinical practice to predict arrhythmias in some clinical conditions, including muscular dystrophy . In particular, we previously showed that the electrocardiographic (P‐wave duration and dispersion) and echocardiographic noninvasive indicators of atrial conduction heterogeneity (intraleft and interatrial electromechanical delay indices) were significantly increased in DM1 patients with AF compared to those with no arrhythmias and were independent predictors of AF onset .…”

Impact of Continuous Positive Airway Pressure Therapy on Atrial Electromechanical Delay in Obesity‐Hypoventilation Syndrome Patients

“…27 It has been studied in some clinical conditions, [28][29][30][31] and it was found that AEMD is significantly correlated with the prolonged maximum P-wave duration, P-wave dispersion, and degree of histopathological changes. [32][33][34] Previous studies evaluated the predictive role of intra-left atrial electromechanical delay for paroxysmal atrial fibrillation recurrence after cardioversion, [35][36][37] lone atrial fibrillation attack, 38 new-onset AF after acute myocardial infarction, 39 occurrence of atrial arrhythmias in adult patients with congenital heart diseases, 40 myotonic dystrophy type 1, 41 and atrial septal aneurysm. 42…”