Assessment of echocardiographic left atrialenlargement in patients with atrial fibrillation. An electrovectorcardiographic study

Bartall, Haim; Desser, Kenneth B.; Benchimol, Alberto; Massey, Bettie Jo

doi:10.1016/s0022-0736(78)80127-7

Cited by 13 publications

(4 citation statements)

References 9 publications

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“…The results of these studies are conflicting. While some investigators 1,18 have found larger fibrillatory waves in patients with LA enlargement, others, 2-4 similar to the results of the present study, have not.…”

Section: Determinants Of Fibrillatory Wave Formsupporting

confidence: 86%

Electrocardiographic Characteristics in Patients with Nonrheumatic Atrial Fibrillation and Their Relation to Echocardiographic Parameters

Bollmann

Binias

Sonne

et al. 2001

Pacing Clinical Electrophis

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The aim of this study was to determine the relation between (1) ECG fibrillatory wave amplitude and left atrial diameter and left atrial appendage (LAA) flow velocity using different ECG recording techniques, and (2) ECG fibrillatory frequency and frequency of LAA contractions in patients with nonrheumatic AF. In 36 patients (22 men, 14 women, mean age 61 +/- 11 years) with persistent AF, ECG recordings were performed using a standard 12-lead EGG and an orthogonal EGG lead system using a high gain, high resolution ECG. AF was classified as coarse (fibrillatory amplitude > or = 1 mm) orfine (fibrillatory amplitude < 1 mm) in leads I, aVF, V1 and corresponding leads X, Y, and Z. Fibrillatory frequency from the ECG was determined by subtracting averaged QRST complexes and applying a Fourier analysis to the resulting signal. Doppler flow was obtained from LAA during transesophageal echocardiography and LAA emptying velocity was determined. Fourier analysis was also applied to the Doppler signal generating the frequency of LAA contractions. Coarse AF was observed in 0, 9, and 18 patients in leads I, aVF, and V, respectively. It was more often (P < 0.05) detected in corresponding leads X (n = 13), Y (n = 31), and Z (n = 23). Fine AF in lead X was associated with a reduced LAA velocity (33 +/- 16 cm/s in coarse AF vs 22 +/- 13 cm/s in fine AF, P = 0.05). There was neither a relation between AF coarseness in any other ECG lead and LAA flow velocity, left atrial diameter, or echo contrast. In 25 patients with an active LAA flow, the mean frequency of LAA contractions was 6.8 +/- 0.8 Hz. The corresponding mean frequency obtainedfrom the EGG was 6.7 +/- 0.7 Hz (r = 0.85, P < 0.001). The mean difference between these two measures was 0.04 Hz, and the 95% confidence limits were 0.90 and- 0.82 Hz using the Bland-Altman method. In conclusion, AF coarseness and its relation to LAA flow velocity depend on the ECG recording technique used. LAA contractions represent one mechanical correlate of the electrical fibrillatory activity in AF.

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Section: Determinants Of Fibrillatory Wave Formsupporting

confidence: 86%

Electrocardiographic Characteristics in Patients with Nonrheumatic Atrial Fibrillation and Their Relation to Echocardiographic Parameters

Bollmann

Binias

Sonne

et al. 2001

Pacing Clinical Electrophis

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“…The incidence of mitral regurgi tation in the present study was lower than that of the previous report [12] although both studies examined a Discussion It has been reported that loss of effective atrial con traction, e.g., atrial fibrillation, does not necessarily de velop mitral regurgitation [4], In the present study, how ever, the cases with lone atrial fibrillation had a high incidence of mitral regurgitation. It has been reported that the cases with atrial fibrillation show left atrial dila tation [5,6], and that left atrial dilatation develops mitral regurgitation [7], The mechanism of this mitral regurgitation was explained that dilatation of the left atrial posterior wall causes a displacement of the poste rior mitral leaflet, resulting in mitral regurgitation [7], In the present study, however, no abnormalities of the con figuration of mitral leaflets were detected by two-dimen sional echocardiography. A difference noted between the cases with atrial fibrillation and the controls was the size of mitral anulus.…”

Section: Mitral Regurgitationcontrasting

confidence: 56%

Mitral Annular Dilatation: The Contribution of Left Atrial Size

Izumi¹,

Morioka²,

Kobayashi³

et al. 1989

Am J Noninvas Cardiol

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Left ventricular size has been thought to be a major factor determining the size of the mitral anulus. In the present study, the contribution of left atrial size to the mitral annular size was explored in 38 cases of lone atrial fibrillation and 39 healthy subjects with a sinus rhythm. A color Doppler flow imaging system was employed. Both the left atrial dimension and the mitral annular diameter were significantly larger in lone atrial fibrillation than in healthy subjects. The left atrial dimension was found to have a significant correlation with the mitral annular diameter (r = 0.7, p < 0 .005). Of 39 healthy subjects, 5 (13%) had mitral regurgitation of which maximum distance of the regurgitant stream was less than 2 cm. The cases with lone atrial fibrillation had a high incidence of mitral regurgitation (23/38, 61%); in 70% of the cases having mitral regurgitation, the maximum distance of the regurgitant stream was 2 cm or more. The site of origin of mitral regurgitation was the center of the orifice in all cases. These results suggest that in lone atrial fibrillation, left atrial dilatation leads to the mitral annular dilatation and then to mitral regurgitation from the center of the orifice. Thus, the left atrial dimension can be regarded as one of the important factors determining the mitral annular diameter.

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“…New methods for correct AF detection were sought. Bartall et al (1978) compared the accuracy of AF detection from a standard 12-lead ECG and a VCG. They concluded that VCG measured by Frank lead system achieves a higher sensitivity for the detection of echocardiographically detectable left atrial enlargement and a higher success rate of AF detection.…”

Section: Heart Disease Analysis From Vectorcardiographymentioning

confidence: 99%

Review of Processing Pathological Vectorcardiographic Records for the Detection of Heart Disease

Vondrak

Penhaker

2022

Front. Physiol.

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Vectorcardiography (VCG) is another useful method that provides us with useful spatial information about the electrical activity of the heart. The use of vectorcardiography in clinical practice is not common nowadays, mainly due to the well-established 12-lead ECG system. However, VCG leads can be derived from standard 12-lead ECG systems using mathematical transformations. These derived or directly measured VCG records have proven to be a useful tool for diagnosing various heart diseases such as myocardial infarction, ventricular hypertrophy, myocardial scars, long QT syndrome, etc., where standard ECG does not achieve reliable accuracy within automated detection. With the development of computer technology in recent years, vectorcardiography is beginning to come to the forefront again. In this review we highlight the analysis of VCG records within the extraction of functional parameters for the detection of heart disease. We focus on methods of processing VCG functionalities and their use in given pathologies. Improving or combining current or developing new advanced signal processing methods can contribute to better and earlier detection of heart disease. We also focus on the most commonly used methods to derive a VCG from 12-lead ECG.

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Assessment of echocardiographic left atrialenlargement in patients with atrial fibrillation. An electrovectorcardiographic study

Cited by 13 publications

References 9 publications

Electrocardiographic Characteristics in Patients with Nonrheumatic Atrial Fibrillation and Their Relation to Echocardiographic Parameters

Electrocardiographic Characteristics in Patients with Nonrheumatic Atrial Fibrillation and Their Relation to Echocardiographic Parameters

Mitral Annular Dilatation: The Contribution of Left Atrial Size

Review of Processing Pathological Vectorcardiographic Records for the Detection of Heart Disease

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