Echocardiographic assessment in patients with atrial fibrillation requires distinguishing between functionally relevant status using averaging methods and best possible hemodynamic status using the index beat method.
How should echocardiographic assessment of atrial, ventricular, and valvular function be performed in patients with atrial fibrillation?
This expert proposal provides guidance on overcoming the challenges of varying heart rates during echocardiography in patients with atrial fibrillation by utilizing averaging or index beat methods.
Echocardiography in patients with atrial fibrillation is challenging due to the varying heart rate. Thus, the topic of this expert proposal focuses on an obvious gap in the current recommendations about diagnosis and treatment of atrial fibrillation (AF)-the peculiarities and difficulties of echocardiographic imaging. The assessment of systolic and diastolic function-especially in combination with valvular heart diseases-by echocardiography can basically be done by averaging the results of echocardiographic measurements of the respective parameters or by the index beat approach, which uses a representative cardiac cycle for measurement. Therefore, a distinction must be made between the functionally relevant status, which is characterized by the averaging method, and the best possible hemodynamic status, which is achieved with the most optimal left ventricular (LV) filling according to the index beat method with longer previous RR intervals. This proposal focuses on left atrial and left ventricular function and deliberately excludes problems of echocardiography when assessing left atrial appendage in terms of its complexity. Echocardiography of the left atrial appendage is therefore reserved for its own expert proposal.
Hagendorff et al. (Mon,) conducted a review in Atrial fibrillation. Echocardiography was evaluated. Echocardiographic assessment in patients with atrial fibrillation requires distinguishing between functionally relevant status using averaging methods and best possible hemodynamic status using the index beat method.