Clinical Utility of Atrial Electromechanical Conduction Time Measured with Speckle Tracking Echocardiography after Catheter Ablation in Patients with Atrial Fibrillation: A Validation Study with Electroanatomical Mapping.

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  • Additional Information
    • Subject Terms:
      PULMONARY veins; ACADEMIC medical centers; ATRIAL fibrillation; CATHETER ablation; CHI-squared test; ELECTROCARDIOGRAPHY; ELECTROPHYSIOLOGY; HEART atrium; HEART conduction system; RESEARCH methodology; PROBABILITY theory; RESEARCH evaluation; T-test (Statistics); CONTROL groups; INTER-observer reliability; DATA analysis software; DESCRIPTIVE statistics; MANN Whitney U Test; INTRACLASS correlation; SURGERY
    • Subject Terms:
      JAPAN
    • Abstract:
      Purpose Our recent report demonstrated that atrial electromechanical conduction time ( EMT-ε) measured with speckle tracking echocardiography could predict cardiac events in patients with pathological left ventricular hypertrophy. This study aimed to validate EMT-ε by comparison with electroanatomical mapping and to investigate the clinical utility of EMT-ε in patients with atrial fibrillation ( AF) undergoing catheter ablation. Methods Forty-six patients with preserved LV ejection fraction ( LVEF ≥ 50%) undergoing pulmonary vein isolation ( PVI) for AF were studied. Atrial electrical conduction delay was determined by measuring atrial electrical activation time ( EAT) using three-dimensional electroanatomical mapping just after PVI. Echocardiographic parameters were acquired within 24 hours and at 6 months after PVI. The study also included 10 control subjects. Results AF patients had a larger left atrial ( LA) volume index ( LAVI) and more prolonged EMT-ε compared with control subjects. According to the validation study, EAT was closely related to EMT-ε and a′, and this association was independent of LAVI and the presence of persistent AF ( EMT-ε: R2 = 0.342, P < 0.0001, a′: R2 = 0.337, P < 0.0001). At 6 months after PVI, LAVI and EMT-ε were significantly improved. During continued follow-up beyond 6 months (total follow-up, 26 ± 12 months), the EMT-ε shortening at 6 months after PVI was significantly greater in AF-free patients than patients with AF recurrence. Conclusions: This study suggested that the EMT-ε could be a useful echocardiographic marker of LA electromechanical abnormalities in patients with AF. [ABSTRACT FROM AUTHOR]