Delayed right atrial lateral electromechanical coupling relative to the septal one can be associated with paroxysmal atrial fibrillation

H. Karapinar, G. Acar, C. Kirma, Z. Kaya, Y. Karavelioglu, Z. Kucukdurmaz, O. Esen, E. Alizade, T. Dasli, D. Sirma, A.M. Esen

Department of Cardiology, Medical School, Cumhuriyet University, Sivas, Turkey. gokselacar81@hotmail.com

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• Cardiology

BACKGROUND: Non-invasive prediction of paroxysmal atrial fibrillation (PAF) is one of the most recent interests of cardiology.

AIM: The current study investigates the relationship between the atrial electromechanical coupling time (EMCT) and PAF.

PATIENTS AND METHODS: A group of 35 patients with PAF was compared with a group of 37 subjects without PAF. Pulsed wave tissue Doppler evaluations of atrial walls were performed from apical four chambers view under ECG monitoring. The time intervals from the onset of P wave to the onset of late diastolic wave (A’) at right atrial wall (P-RA), interatrial septum (P-IAS), and left atrial wall (P-LA, maximum EMCT) were measured. The right atrial EMCT (P-RA minus P-IAS), left atrial EMCT (P-LA minus P-IAS) and interatrial EMCT (P-LA minus P-RA) were computed. A’ wave velocities were measured from each atrial wall.

RESULTS: RA (16.0±13.1 vs. −8.7±18.6 ms, p < 0.001) and maximum (91.5±32.6 vs. 72.0±23.1 ms, p = 0.001) EMCT were longer, RA A’ velocity was higher in the patient group. There were no differences between the groups in LA and interatrial EMCT, and septal and LA A’ velocities. Regression analysis revealed that only RA [OR: 1.148 (1.041-1.267), p = 0.006] and maximum [OR: 1.099 (1.009-1.197), p = 0.031] EMCT were independent variables for PAF. In order to predict patients with PAF, we have chosen +7.5 msn for the RA EMCT which yielded 69% sensitivity and 71.4% specificity to predict patients.

CONCLUSIONS: Delayed RA lateral EMCT relative to septal one and delayed maximum EMCT detected by tissue Doppler could be a valuable method for identifying patients with PAF.

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