Investigation of the atrial conduction time measured by tissue Doppler imaging at the left atrial appendage and the actual electrical conduction time: consideration of left atrial remodeling in atrial fibrillation patients

2016 ◽  
Vol 48 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Yuichi Hori ◽  
Shiro Nakahara ◽  
Naofumi Anjo ◽  
Ayako Nakagawa ◽  
Naoki Nishiyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Electrical Conduction ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Atrial Remodeling ◽  
Conduction Time ◽  
Left Atrial Remodeling ◽  
Atrial Conduction Time

scholarly journals Assessment of left atrial electro-mechanical delay to predict atrial fibrillation in hypertrophic cardiomyopathy

2020 ◽  
Author(s):  
Catherina Tjahjadi ◽  
Yasmine L Hiemstra ◽  
Pieter van der Bijl ◽  
Stephan M Pio ◽  
Marianne Bootsma ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Tissue Doppler ◽  
P Wave ◽  
Doppler Imaging ◽  
Conduction Time ◽  
Atrial Conduction Time ◽  
New Onset

Abstract Aims Atrial fibrillation (AF) is frequently observed in hypertrophic cardiomyopathy (HCM) and is associated with poor clinical outcome. Total atrial conduction time, estimated by tissue Doppler imaging (TDI), the so-called PA-TDI duration, reflects the left atrial (LA) structural and electrical remodelling. The aim of this study was to evaluate the association between PA-TDI and new-onset AF in patients with HCM. Methods and results From a large cohort of patients with HCM, 208 patients (64% male, mean age 53 ± 14 years) without AF were selected. PA-TDI duration was measured from the onset P wave on electrocardiogram to the peak A′ wave of the lateral LA wall using TDI. The incidence of new-onset AF was 20% over a median follow-up of 7.3 (3.5–10.5) years. Patients with incident AF had longer PA-TDI duration when compared with patients without AF (133.7 ± 23.0 vs. 110.5 ± 30.0 ms, P < 0.001). PA-TDI duration was independently associated with new-onset AF (hazard ratio: 1.03, 95% confidence interval: 1.01–1.05, P < 0.001). Conclusion Prolonged PA-TDI duration was independently associated with new-onset AF in patients with HCM. This novel parameter could be useful to risk-stratify patients with HCM who are at risk of having AF.

scholarly journals Predictive value of various Doppler-derived parameters of atrial conduction time for successful atrial fibrillation ablation

2015 ◽  
Vol 2 (4) ◽  
pp. 99-107 ◽  
Author(s):  
Miriam Shanks ◽  
Lucas Valtuille ◽  
Jonathan B Choy ◽  
Harald Becher
Keyword(s):  
Predictive Value ◽  
Left Atrial ◽  
Atrial Tachycardia ◽  
Atrial Remodeling ◽  
Conduction Time ◽  
Left Atrial Remodeling ◽  
Af Ablation ◽  
Atrial Conduction Time ◽  
Pulsed Wave Doppler ◽  
History Of

Various Doppler-derived parameters of left atrial electrical remodeling have been demonstrated to predict recurrence of atrial fibrillation (AF) after AF ablation. The aim of this study was to compare three Doppler-derived measures of atrial conduction time in patients undergoing AF ablation, and to investigate their predictive value for successful procedure. In 32 prospectively enrolled patients undergoing the first AF ablation, atrial conduction time was estimated by measuring the time delay between the onset of P-wave on the surface ECG to the peak of the a′-wave on the pulsed-wave Doppler and color-coded tissue Doppler imaging of the left atrial lateral wall, and to the peak of the A-wave on the pulsed-wave Doppler of the mitral inflow. There was a significant difference in the baseline atrial conduction time measured by different echocardiographic techniques. Most (88%) patients had normal or only mildly dilated left atrium. At 6 months, 12 patients (38%) had recurrent AF/atrial tachycardia. The duration of history of AF was the only predictor of AF/atrial tachycardia recurrence following the first AF ablation (P=0.024; OR 1.023, CI 1.003–1.044). A combination of normal left atrial volume and history of paroxysmal AF of ≤48 months was associated with the best outcome. Predictive value of the Doppler derived parameters of atrial conduction time may be reduced in the early stages of left atrial remodeling. Future studies may determine which echocardiographic parameter correlates best with the extent of left atrial remodeling and is most predictive of successful AF ablation.

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