Atrial Electromechanical Interval Can Identify Patients With Paroxysmal Atrial Fibrillation and is Associated With CHADS(2) Score and Peak Velocity of Left Atrial Appendage

作者：Chao Tze Fan; Sung Shih Hsien; Wang Kang Ling; Tsao Hsuan Ming; Lin Yenn Jiang; Chang Shih Lin; Lo Li Wei; Hu Yu Feng; Tuan Ta Chuan; Suenari Kazuyoshi; Li Cheng Hung; Liu Shuen Hsin; Wu Tsu Juey; Yu Wen Chung; Chen Shih Ann^*

来源：Journal of Cardiovascular Electrophysiology, 2011, 22(12): 1325-1330.

DOI：10.1111/j.1540-8167.2011.02115.x

• atrial electromechanical interval
• CHADS(2) score
• left atrial appendage
• paroxysmal atrial fibrillation
• stroke

Electromechanical Interval and Paroxysmal Atrial Fibrillation. Introduction: It is difficult to discriminate patients with and without paroxysmal atrial fibrillation (PAF). The atrial electromechanical interval determined by the transthoracic echocardiogram is demonstrated to be a predictor of new onset AF. The aim of our study was to investigate whether the electromechanical interval is a useful parameter to identify patients with PAF.
Methods and Results: A total of 297 patients (PAF group = 103; control group = 194) with mean age of 59.4 +/- 12.4 years were enrolled. The electromechanical interval (PA-PDI) defined as the time interval from the initiation of the P-wave deflection to the peak of the mitral inflow A wave on the pulse-wave Doppler imaging was measured for every patient. Patients with PAF had significantly longer PA-PDI intervals compared with that of patients without it (152.7 +/- 13.8 ms vs 133.4 +/- 16.8 ms). The area under ROC curve based on the PA-PDI interval to diagnose PAF was 0.803 (95% confidence interval = 0.755-0.851, P < 0.001). At the cut-off value of 142 ms, the sensitivity and specificity in identifying PAF were 77.7% and 80.1%, respectively. In the PAF group, the PA-PDI interval was closely associated with the CHADS(2) score and inversely related with the peak velocity of left atrial appendage.
Conclusions: The PA-PDI interval may be a useful parameter to identify patients with PAF. Further studies are necessary to evaluate the usefulness of PA-PDI intervals in diagnosing PAF in addition to the current methods and tools. (J Cardiovasc Electrophysiol, Vol. 22, pp. 1325-1330, December 2011)

• 出版日期2011-12