Key result
Longer lateral atrial electromechanical delay was independently associated with paroxysmal atrial fibrillation (OR 1.25 per 10 ms increase) compared to patients with multiple cardiovascular risk factors and healthy controls.
Why the study?
The usefulness of tissue Doppler imaging-derived atrial electromechanical delay for detecting paroxysmal atrial fibrillation remained unknown when analyzed using patients at high risk for atrial fibrillation as controls.
Does Tissue Doppler-derived atrial electromechanical delay identify patients with paroxysmal atrial fibrillation compared to healthy individuals and those with multiple cardiovascular risk factors?
Cross-Sectional (n=146)
No
Does Tissue Doppler-derived atrial electromechanical delay identify patients with paroxysmal atrial fibrillation compared to healthy individuals and those with multiple cardiovascular risk factors?
Odds Ratio: 1.25 (95% CI 1.03–1.52)
p-value: p=0.023
Tissue Doppler-derived lateral atrial electromechanical delay is independently associated with paroxysmal atrial fibrillation and can help identify patients at risk, even when compared to patients with multiple cardiovascular risk factors.
Supports atrial electromechanical delay for AF risk stratification research; leaves open incremental predictive value and clinical utility.
Background: Tissue Doppler imaging (TDI)-derived atrial electromechanical delay (AEMD) has been reported to be useful for detecting paroxysmal atrial fibrillation (PAF). However, its usefulness remains unknown when analyzed along with patients seemingly at high-risk for AF as controls. From this standpoint, we investigated whether AEMD would be of use for identifying patients with PAF. Methods: We retrospectively analyzed TDI recordings to obtain AEMD in 63 PAF patients. Thirty-three patients with multiple cardiovascular risk factors (MRFs) but without history of AF and 50 healthy individuals served as disease and healthy controls, respectively. AEMD was defined as the time-interval between the electrocardiogram P-wave and the beginning of the spectral TDI-derived A’ for the septal (septal EMD) and lateral (lateral EMD) sides of the mitral annulus. Results: There was no significant difference in the left atrial volume index between PAF patients and disease controls (28 ± 9 mL/m 2 vs. 27 ± 5 mL/m 2 ). PAF patients had longer AEMD, particularly for the lateral EMD (75 ± 23 ms), compared with disease (62 ± 22 ms, P = 0.009) and healthy (54 ± 24 ms, P <0.001) controls. Multivariate logistic regression analysis revealed that the lateral EMD (OR 1.25, 95%CI 1.03 – 1.52, P = 0.023), along with the left atrial volume index (OR 2.25, 95%CI 1.44 – 3.51, P <0.001), was one of the significant independent associates of identifying PAF patients. Conclusions: This cross-sectional study indicates that even analyzed together with MRFs patients, AEMD remains useful for identifying patients at risk for AF. Our results need to be confirmed by a large-scale prospective study.
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Akamatsu et al. (2020) conducted a cross-sectional in Paroxysmal Atrial Fibrillation (n=146). Tissue Doppler-derived lateral atrial electromechanical delay (AEMD) vs. Disease controls and healthy controls was evaluated on Identification of paroxysmal atrial fibrillation (OR 1.25, 95% CI 1.03-1.52, p=0.023). Longer lateral atrial electromechanical delay was independently associated with paroxysmal atrial fibrillation (OR 1.25 per 10 ms increase) compared to patients with multiple cardiovascular risk factors and healthy controls.
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