Atrial electromechanical sequence in normal subjects and patients with DDD pacemakers.

Wang, Ke; Xiao, Han; Fujimoto, Shinichi; Gibson, D. G.

doi:10.1136/hrt.74.4.403

Cited by 41 publications

(42 citation statements)

References 18 publications

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“…These are PWD that is an electrocardiographic parameter and AEMD and ACT that are measured by TDI study (13)(14)(15)(16)(17) . In addition, in various contributing factors to develop AF such as obstructive sleep apnoea, diastolic dysfunction, dilated cardiomyopathy and hypertension the prolongation of AEMD during sinus rhythm has been reported (12,(18)(19)(20)(21) .…”

Section: Discussionmentioning

confidence: 99%

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Güler¹

2017

Kosuyolu Heart Journal

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Introduction: AF in patients with mitral stenosis (MS) causes significant morbidity and mortality. PMBV, which is a treatment of choice for patients with MS, is a highly successful procedure that provides significant improvement in symptoms and echocardiographic parameters. In this study we aimed to demonstrate the probable effects of PMBV on novel echocardiographic and electrocardiographic parameters that can predict the development of AF in 1-year period in patients with MS. Patients and Methods:Twenty-eight patients with moderate or severe rheumatic MS (mean age 37.6 ± 7.4 years; 14 (50%) males) were enrolled this study. All patients who were eligible for this procedure underwent comprehensive echocardiographic examinations with evaluation of ACT measured using tissue Doppler imaging (TDI) before PMBW and repeated at the end of the 1 year after successful PMBV. In addition, 12-lead ECGs were recorded for each patient 1 day before PMBV for the evaluation of baseline maximum and minimum P-wave duration and P-wave dispersion (PWD); this was repeated at the end of the 1 year after successful PMBV.Results: ACT (148.1 ± 20.5 vs 121.3 ± 20.5 p< 0.001), P-max (151.7 ± 15.8 vs 137.3 ± 15.6 p< 0.001) and PWD (84.7 ± 18.8 vs 71.1 ± 18.5 p< 0.001) were found to be significantly decreased after PMBV. A strong positive correlation was detected between ACT, P-max, PWD, LAVi ve PAPs before and after PMBV. In addition, there was a strong correlation between Δ values that were measured by subtracting the baseline measurements from the post-PMBV measurements. Accordingly, ΔACT was correlated with ΔP-max ve ΔPWD (r= 0.5 p= 0.007 and r= 0.55 p= 0.002, respectively). ΔACT, ΔP-max and ΔPWD correlated significantly with only ΔLAVi and ΔPAP in echocardiographic parameters. Conclusion:This study demonstrated that atrial conduction properties that have also been evaluated with ECG and TDI studies significantly correlate with other echocardiographic parameters in patients with MS. In addition, significant improvement occurred in these parameters at the end of the 1 year after PMBV. Further prospective investigations may provide useful data for the detection of the relation between atrial electromechanical characteristics and development of AF in patients with MS.Key Words: Rheumatic mitral stenosis; atrial fibrillation; atrial conduction tine P-wave dispersion; percutaneous mitral balloon valvuloplasty Mitral Darlığı Olan Hastalarda Atriyal Elektiriksel ve Elektromekanik Özellikler ÖZETGiriş: Mitral darlığı olan hastalarda atriyal fibrilasyon (AF) önemli bir mortalite ve morbidite nedenidir ve bu hastalarda perkütan mitral balon valvüloplasti (PMBV) semptomlarda ve ekokardiyografik parametrelerde önemli düzelme sağlayan başarılı bir girişimdir. Bu çalışmada mitral darlıklı hastalarda PMBV'nin AF gelişimini predikte edebilen yeni ekokardiyografik ve elektrokardiyografik parametreler üzerindeki bir yıllık dönemdeki etkisinin gösterilmesi amaçlanmıştır. Hastalar ve Yöntem:Orta ve ileri mitral darlığı olan 28 hasta (ortalama yaş 37....

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Section: Discussionmentioning

confidence: 99%

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Güler¹

2017

Kosuyolu Heart Journal

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“…Also, there are some echocardiographic methods to measure interatrial conduction times by the evaluation www.cardiologyjournal.org of cardiac electromechanical events. The time interval between the electrocardiographic P wave and the atrial contraction detected by M-mode or Doppler echocardiography is defined as atrial electromechanical delay [9][10][11]. Atrial mechanical activity can be detected from different atrial regions by tissue Doppler echocardiography with high temporal resolution [12].…”

Section: Introductionmentioning

confidence: 99%

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Deniz

Şahiner²,

Aytemir³

et al. 2012

Cardiol J

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“…However, the absolute value of the global interatrial delay did not differ between the groups. Physiologically, RA precedes LA contraction 12,[15][16][17] and according to Barletta et al who have studied atrial contraction sequence in 66 healthy subjects, the mean interatrial delay amounts to 17.7±2.8 ms (−40-60 ms); 15 however, occasionally a reversed atrial contraction sequence can be observed. So far, 2 groups of investigators have examined the atrial contraction sequence during MAP, and in all their patients 1 of the atrial leads was placed in the RAA.…”

Section: Discussionmentioning

confidence: 99%

Atrial Function During Different Multisite Atrial Pacing Modalities in Patients With Bradycardia - Tachycardia Syndrome

Lewicka

Dąbrowska−Kugacka

Ruciński

et al. 2009

Circ J

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trial fibrillation (AF) is the most frequent arrhythmia observed in patients with an implanted pacemaker, and there are multiple factors for its etiology. [1][2][3] It has been shown that atrial pacing may have a preventive effect on AF recurrence. The antiarrhythmic effect of atrial pacing is not always immediate, but can be progressive in some patients, 4 and some pacing algorithms may also be useful. 5 Intra-and interatrial conduction disturbances are well-known factors predisposing to AF development and/or maintenance. Thus, the choice of atrial pacing site may play an important role in providing atrial electrical activation synchrony and diminishing the influence of abnormal atrial conduction on the incidence of AF. Some investigators have suggested that multisite atrial pacing (MAP), which incorporates 1 electrode in the right atrial appendage (RAA) and the other in the coronary sinus (CS) ostium area (dualsite atrial pacing) or in the mid-or distal CS (bi-atrial pacing), might be more beneficial than conventional RAA pacing. [6][7][8] Recently, our group proposed a novel method of MAP incorporating the Bachmann's bundle (BB) and CS ostium region. 9 This novel pacing modality presumes "double electrical resynchronization" of the left atrium (LA) and its antiarrhythmic effect has been shown in patients with AF. 9 However, up till now neither the optimal atrial pacing site nor the superiority of multisite over single-site atrial pacing has been ultimately determined.The aim of the study was to compare the hemodynamic effects of 2 MAP modalities and to determine the influence of the RA pacing lead positioning in the BB region compared with the typical RAA site on atrial contraction synchrony. It is presumed that beneficial hemodynamic effect of MAP would support its antiarrhythmic effect. Methods Patient PopulationWe studied 62 consecutive patients in whom MAP was conducted because of (1) sinus node dysfunction with class I or II indications for permanent cardiac pacing; (2) documented symptomatic AF recurrence (paroxysmal or persistent); (3) signs of advanced intra-and interatrial conduction delay: sinus P-wave duration ≥120 ms on the surface ECG; (4) no evidence of 2 nd or 3 rd degree atrioventricular (AV) block; and (5) Piotr Rucinski, MD*; Dariusz Kozlowski, MD, PhD; Grzegorz Raczak, MD, PhD; Andrzej Kutarski, MD, PhD* Background: Multisite atrial pacing (MAP) was introduced to improve atrial electrical synchrony and prevent recurrence of atrial fibrillation (AF). Methods and Results: In the present study there were 57 patients with sinus node disease, AF recurrence and prolonged P-wave on ECG with 2 MAP modalities. In all patients 1 lead was implanted in the coronary sinus (CS) ostium area. In the right atrial appendage (RAA)+CS group (28 patients) the other atrial lead was in the RAA, and in the BB+CS group (29 patients) in the Bachmann's bundle (BB) region. Tissue Doppler was used to register the electromechanical delay (EMD) in the atrial walls and estimate the atrial contraction synchrony. Cardiac o...

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Atrial electromechanical sequence in normal subjects and patients with DDD pacemakers.

Cited by 41 publications

References 18 publications

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Atrial Function During Different Multisite Atrial Pacing Modalities in Patients With Bradycardia - Tachycardia Syndrome

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