Key result
The atrial electromechanical interval (PA-PDI) effectively identified patients with paroxysmal atrial fibrillation, yielding an area under the ROC curve of 0.803 (95% CI 0.755-0.851; P<0.001).
Why the study?
Does the atrial electromechanical interval (PA-PDI) measured by echocardiography identify patients with paroxysmal atrial fibrillation?
Case-Control (n=297)
Does the atrial electromechanical interval (PA-PDI) measured by echocardiography identify patients with paroxysmal atrial fibrillation?
Effect estimate: AUC 0.803 (95% CI 0.755-0.851)
p-value: p=<0.001
The atrial electromechanical interval (PA-PDI) is significantly prolonged in patients with paroxysmal atrial fibrillation and may be a useful echocardiographic marker for identifying these patients.
PA-PDI may identify paroxysmal AF on echocardiography; hypothesis-generating and requires prospective validation before clinical adoption.
INTRODUCTION: It is difficult to discriminate patients with and without paroxysmal atrial fibrillation (PAF). The atrial electromechanical interval determined by the transthoracic echocardiogram is demonstrated to be a predictor of new onset AF. The aim of our study was to investigate whether the electromechanical interval is a useful parameter to identify patients with PAF. METHODS AND RESULTS: A total of 297 patients (PAF group = 103; control group = 194) with mean age of 59.4 ± 12.4 years were enrolled. The electromechanical interval (PA-PDI) defined as the time interval from the initiation of the P-wave deflection to the peak of the mitral inflow A wave on the pulse-wave Doppler imaging was measured for every patient. Patients with PAF had significantly longer PA-PDI intervals compared with that of patients without it (152.7 ± 13.8 ms vs 133.4 ± 16.8 ms). The area under ROC curve based on the PA-PDI interval to diagnose PAF was 0.803 (95% confidence interval = 0.755-0.851, P < 0.001). At the cut-off value of 142 ms, the sensitivity and specificity in identifying PAF were 77.7% and 80.1%, respectively. In the PAF group, the PA-PDI interval was closely associated with the CHADS(2) score and inversely related with the peak velocity of left atrial appendage. CONCLUSIONS: The PA-PDI interval may be a useful parameter to identify patients with PAF. Further studies are necessary to evaluate the usefulness of PA-PDI intervals in diagnosing PAF in addition to the current methods and tools.
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Chao et al. (2011) conducted a case-control in Paroxysmal atrial fibrillation (n=297). Atrial electromechanical interval (PA-PDI) measurement vs. Patients without paroxysmal atrial fibrillation was evaluated on Diagnosis of paroxysmal atrial fibrillation (AUC 0.803, 95% CI 0.755-0.851, p=<0.001). The atrial electromechanical interval (PA-PDI) effectively identified patients with paroxysmal atrial fibrillation, yielding an area under the ROC curve of 0.803 (95% CI 0.755-0.851; P<0.001).
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