Interatrial mechanical dyssynchrony worsened atrial mechanical function in sinus node disease with or without paroxysmal atrial fibrillation

Journal of Cardiovascular Electrophysiology
Mei WangHung-Fat Tse


Atrial electromechanical dysfunction might contribute to the development of atrial fibrillation (AF) in patients with sinus node disease (SND). The aim of this study was to investigate the prevalence and impact of atrial mechanical dyssynchrony on atrial function in SND patients with or without paroxysmal AF. We performed echocardiographic examination with tissue Doppler imaging in 30 SND patients with (n = 11) or without (n = 19) paroxysmal AF who received dual-chamber pacemakers. Tissue Doppler indexes included atrial contraction velocities (Va) and timing events (Ta) were measured at midleft atrial (LA) and right atrial (RA) wall. Intraatrial synchronicity was defined by the standard deviation and maximum time delay of Ta among 6 segments of LA (septal/lateral/inferior/anterior/posterior/anterospetal). Interatrial synchronicity was defined by time delay between Ta from RA and LA free wall. There were no differences in age, P-wave duration, left ventricular ejection fraction, LA volume, and ejection fraction between with or without AF. Patients with paroxysmal AF had lower mitral inflow A velocity (70 +/- 19 vs 91 +/- 17 cm/s, P = 0.005), LA active empting fraction (24 +/- 14 vs 36 +/- 13%, P = 0.027), mean Va of LA (2.6 +/- ...Continue Reading


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