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

Fujii, Akiko; Inoue, Kentaro; Nagai, Takayuki; Nishimura, Kazuhisa; Uetani, Teruyoshi; Suzuki, Jun; Funada, Junichi; Okura, Takafumi; Higaki, Jitsuo; Ogimoto, Akiyoshi

doi:10.1111/echo.13259

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Modern echocardiographic techniques, such as myocardial deformation indices such as Doppler-derived regional atrial strain, have also been successfully used to quantify atrial function. [ 42 43 ] Speckle tracking echocardiography (STE) is an advanced imaging technique enabling the assessment of impairment of LA reservoir function,[ 44 ] potentially caused by reduced atrial compliance due to atrial fibrosis.…”

Section: N Oninvasive I Maging ...mentioning

confidence: 99%

Multimodality Imaging for Atrial Fibrosis Detection in the Era of Precision Medicine

Barletta¹,

Mazzocchetti²,

Parollo³

et al. 2021

Journal of Cardiovascular Echography

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In recent years, atrial fibrillation (AF) has increasingly become a focus of attention because it represents the most encountered arrhythmia in clinical practice and a major cause of morbidity and mortality. Issues underlying AF have long been debated; nevertheless, electrical, contractile, and structural remodeling is demonstrated to be the pivotal contributor to arrhythmic substrate. Fibrosis is a hallmark of arrhythmogenic structural remodeling, resulting from an accumulation of fibrillar collagen deposits, as a reparative process to replace degenerating myocardium with concomitant reactive fibrosis, which causes interstitial expansion. Although the precise role of fibrosis in AF initiation and maintenance remains to be fully elucidated, a better definition of its extent and distribution may assist in designing individually tailored ablation approaches and improving procedure outcomes by targeting the fibrotic substrates with an organized strategy employing imaging resources. A deep comprehension of the mechanisms underlying atrial fibrosis could be crucial to setting up improved strategies for preventing AF-promoting structural remodeling. Imaging modalities such as echocardiography, cardiac computed tomography, and cardiac magnetic resonance, combined sometimes with invasive electroanatomical mapping, could provide valuable information for the optimal patients’ management if their use is not limited to cardiac anatomy study but extended to characterize abnormal left atrial substrate. Although pulmonary vein isolation is usually efficacious in treating paroxysmal AF, it is not sufficient for many patients with nonparoxysmal arrhythmias, particularly those with longstanding persistent AF. Noninvasive imaging techniques play a pivotal role in the planning of arrhythmic substrates ablation and show a strong correlation with electro-anatomic mapping, whose novel multipolar mapping catheters allow nowadays a more precise comprehension of atrial substrate. This review aims to explore the impact of the various imaging modalities for the detection of atrial fibrosis and their role in the management of AF.

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Section: N Oninvasive I Maging ...mentioning

confidence: 99%

Multimodality Imaging for Atrial Fibrosis Detection in the Era of Precision Medicine

Barletta¹,

Mazzocchetti²,

Parollo³

et al. 2021

Journal of Cardiovascular Echography

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“…4 Robust and feasible method in diagnosis of LA fibrosis is a challenge in clinical practice. 7 Speckle tracking echocardiography (STE) 5 The extent of LA fibrosis may be also assessed using an electroanatomical mapping (EAM); however, this requires invasive electrophysiological study.…”

Section: Introductionmentioning

confidence: 99%

“…Out of the studies correlating electrophysiological and biochemical surrogate of fibrosis and echocardiographic parameters of LA, only a few data are available from invasive EAM of LA. 7 Speckle tracking echocardiography (STE)…”

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confidence: 99%

Noninvasive assessment of left atrial fibrosis. Correlation between echocardiography, biomarkers, and electroanatomical mapping

et al. 2018

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“…Thus, the probability of recurrence of AF was reduced. It has also been reported that the recurrence of AF was significantly lower in patients with shorter P-εCT than those patients with persistently longer P-εCT for 6 months (31). This also indicates that TACT could play a guiding role in the recurrence of AF after the surgery.…”

Section: Effects Of the Surgery On La Functionmentioning

confidence: 80%

Impact of stand-alone minimally invasive radiofrequency ablation with left atrial appendectomy on left atrial function assessed by echocardiography

Zhang

Sun

et al. 2020

Quant Imaging Med Surg

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Background: Stand-alone minimally invasive radiofrequency (RF) ablation with left atrial (LA) appendectomy has been an effective surgical intervention for non-paroxysmal atrial fibrillation (AF) (NPAF) in patients with a medical history of thromboembolism for secondary stroke prevention. This study sought to assess the impact of this surgery on LA function.Methods: A total of 37 NPAF patients with a medical history of stroke or thromboembolism were enrolled in this prospective observational study, all of whom underwent stand-alone minimally RF ablation with LA appendectomy. Echocardiography was used to evaluate LA function preoperatively and 1 week and 3 months postoperatively. All patients were divided into two groups (Group AF and Group SR) according to whether sinus rhythm (SR) was restored after the surgery. Results:The surgery had no impact on LA function in Group AF. Once NPAF patients were restored to SR, LA minimal volume (LAV min ) decreased immediately compared with pre-operation (22.98±13.76 vs. 17.68±9.52 mL; P<0.05) and consequently LA reservoir function increased, including LAEF (37.69%±12.53% vs. 46.71%±8.53%, P<0.05) and LAEI (66.54%±34.39% vs. 92.15%±31.37%, P<0.05). PA-TDI of Group SR, indicating LA electromechanical coupling, were improved at three months of follow-up because of atrial stunning after the surgery (160.55±26.19 vs. 143.82±20.923 ms, P<0.05). LA contractile function was also improved at three months of follow-up (A-TVI: 2.95±1.16 vs. 5.10±1.85 cm, P<0.05).Conclusions: Stand-alone minimal invasive RF ablation with LA appendectomy had no impact on LA function in AF patients who could not be restored to SR. However, once AF patients were restored to SR after the surgery, LA function could recover better. Meanwhile, thromboembolic events could also be reduced after the surgery.

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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

Abstract: This study suggested that the EMT-ε could be a useful echocardiographic marker of LA electromechanical abnormalities in patients with AF.

Cited by 7 publications

References 31 publications

Multimodality Imaging for Atrial Fibrosis Detection in the Era of Precision Medicine

Multimodality Imaging for Atrial Fibrosis Detection in the Era of Precision Medicine

Noninvasive assessment of left atrial fibrosis. Correlation between echocardiography, biomarkers, and electroanatomical mapping

Impact of stand-alone minimally invasive radiofrequency ablation with left atrial appendectomy on left atrial function assessed by echocardiography

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