Key result
Longer transmitral A-wave acceleration time was a significant predictor of paroxysmal atrial fibrillation (OR 1.02; 95% CI 1.02-1.07; P<0.001).
Why the study?
While transmitral A-wave velocity is known to decrease in paroxysmal atrial fibrillation, the relationship between transmitral A-wave acceleration time and paroxysmal atrial fibrillation is unknown.
Does prolonged transmitral A-wave acceleration time predict paroxysmal atrial fibrillation?
Case-Control (n=140)
Does prolonged transmitral A-wave acceleration time predict paroxysmal atrial fibrillation?
Transmitral A-wave acceleration time >82 ms measured during sinus rhythm may serve as an early echocardiographic marker for detecting paroxysmal atrial fibrillation in patients without left atrial dilation.
May support TMAW-AccT as early PAF marker in sinus rhythm; leaves open incremental value and needs prospective validation.
BACKGROUND: It has been shown that transmitral A-wave (TMAW) is affected in paroxysmal atrial fibrillation (PAF), and decreased left atrial contractions cause a decrease in the TMAW velocity. The relationship between TMAW acceleration time (TMAW-AccT) and PAF is unknown. In this study, the predictive value of TMAW-AccT for PAF was investigated. METHODS: Seventy PAF patients (mean age: 57.8 ± 11.0 years) and 70 control patients (mean age: 58.1 ± 10.5 years) were included in the study. Transthoracic echocardiography was performed in sinus rhythm in all patients. For TMAW-AccT, the time between the basal point of the A-wave and the highest point reached was measured. RESULTS: Transmitral A-wave -AccT was significantly longer in the PAF group than the control group (TMAW-AccT; 88.5 ± 18.1 vs 77.2 ± 16.4 ms, P = .000, respectively). The left atrial diameter and the left atrial volume index were similar between the groups (P = .07, P = .18, respectively). According to a multivariate logistic regression analysis, the TMAW-AccT (OR: 1.02, 95% confidence interval 1.02-1.07, P < .001) was a predictor of PAF. A receiver operating characteristic curve analysis showed a cutoff value of TMAW-AccT of >82 ms (sensitivity: 65.7%, specificity: 64.3%, positive predictive value: 64.8%, negative predictive value: 65.2%). CONCLUSION: Transmitral A-wave-AccT can be used as an early marker in detecting PAF without dilated left atrium.
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Akıllı et al. (2019) conducted a case-control in Paroxysmal atrial fibrillation (n=140). Transmitral A-wave acceleration time (TMAW-AccT) vs. Control patients was evaluated on Paroxysmal atrial fibrillation (OR 1.02, 95% CI 1.02-1.07, p=<.001). Longer transmitral A-wave acceleration time was a significant predictor of paroxysmal atrial fibrillation (OR 1.02; 95% CI 1.02-1.07; P<0.001).
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