Abstract
Aim: Atrial fibrillation is the most common arrhythmia in the population and its prevalance increases with age; and also is the most morbid and mortal arrhythmia. Usually the beginning of the persistant atrial fibrillation is recurrent episodes of the paroxysmal atrial fibrillation (PAF). Prediction of the paroxysmal atrial fibrillation can cause prevention of this arrhythmia and thus prevention of the adverse outcomes. We aimed to investigate tissue Doppler imaging (TDI) and peak acceleration time (pkAcc) parameters that can predict the paroxysmal atrial fibrillation in this study. Material and Methods: 20-73 years old (mean 47,5) 50 individuals that are diagnosed with PAF included the patient group. 50 individuals who have the similar baseline demographic charasteristics with patient group and who have no persistant or PAF included the control group. Transthoracic echocardiogaphic (TTE) evaluation is applied all of the control and study groups. Tissue Doppler parameters and pkAcc is measured in TTE and statistical analyses is performed. Results: In TTE evaluation, left atrium ejection fraction is lower in the patient group than the study group (%50,6 vs. %59,2, p<0,001). In TDI evaluation, the average of E/E’ which was measured from the anterior, inferior, lateral and septal walls of the left ventricle; is found higher in the patient group compared to the control group (8,17 vs. 7,04; p=0,004). When two groups are compared in terms of pkAcc, it was found that patient group is higher, but this difference did not reach the statistical significance (1063 vs. 994, p=0,14). Conclusions: TDI evaluation can play an important role in prediction of paroxysmal atrial fibrillation.
Highlights
Atrial fibrillation is the most common arrhythmia worldwide and related with increased negative outcomes such as increased cerebrovascular accident rate, heart failure and allcause mortality [1]
Paroxysmal atrial fibrillation is defined as atrial fibrillation that can relapse from time to time and always terminate in 7 days spontaneously or by intervention [2,3]
Fifty individuals who had similar demographic characteristics with patient group and who were found to have no persisting AF or paroxysmal atrial fibrillation (PAF) were included in the control group.Paroxysmal atrial fibrillation was defined as AF detected with a 12-lead ECG or rhythm holter monitorization, and with a short duration of 7 days
Summary
Atrial fibrillation is the most common arrhythmia worldwide and related with increased negative outcomes such as increased cerebrovascular accident rate, heart failure and allcause mortality [1]. Tissue Doppler imaging (TDI) is widely used today and has been studied in many cardiac pathologies [5]. MYocardial Doppler In Stress Echocardiography (MYDISE) study showed that TDI velocities are predictors of angiographic illness [6]. The ratio of “E” wave velocity, which is measured from mitral inflow by conventional PW Doppler method, to “E’” velocity measured by TDI method is strongly correlated [7]. Assessment of atrial functions by conventional echocardiography has not been thoroughly investigated and is worth investigating. Modesto et al have shown that strain parameters may be useful in assessing atrial functions in amyloidosis [8]. In a study in which patients with non-valvular AF detected and cardioversion performed were followed for 1 year, a strong correlation was found between sinus rhythm administration and peak "A" velocity after cardioversio[9]
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