Korean Circ J.  2015 Nov;45(6):479-485. 10.4070/kcj.2015.45.6.479.

Comparison of Prolonged Atrial Electromechanical Delays with Different Definitions in the Discrimination of Patients with Non-Valvular Paroxysmal Atrial Fibrillation

• Lee DH
• Choi SY
• Park JS
• Seo JM
• Choi JH
• Cho YR
• Park K
• Kim MH
• Kim YD

• KMID: 2223786
• DOI: http://doi.org/10.4070/kcj.2015.45.6.479

Abstract

BACKGROUND AND OBJECTIVES
Previous studies have evaluated atrial electromechanical delays (AEMDs) with a number of different definitions to discriminate patients with paroxysmal atrial fibrillation (PAF) from controls without PAF. However, their discriminative values for PAF have not previously been directly compared.
SUBJECTS AND METHODS
A total of 65 PAF patients and 130 control subjects matched for age, sex, history of hypertension, and diabetes mellitus were selected. The AEMDi and AEMDp were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic transmitral inflow on pulsed wave Doppler images, respectively. The AEMDim and AEMDpm were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic lateral mitral annular motion on tissue Doppler images, respectively.
RESULTS
There were no significant differences in the clinical characteristics between the two groups. All 4 AEMDs were consistently longer in the PAF group, and proven effective to differentiate the PAF patients from the controls. The AEMDi measurement had a larger area under the curve (AUC) than the other AEMDs, left atrial volume index, and P wave amplitude. However, the AEMDp, AEMDim, and AEMDpm measurements had AUCs similar to those of the left atrial volume index and P wave amplitude.
CONCLUSION
The findings suggest that the AEMDi is better than the other AEMDs for the discrimination of PAF patients from the controls.

Keyword

Atrial fibrillation; Electrocardiography; Echocardiography

MeSH Terms

Area Under Curve
Atrial Fibrillation*
Diabetes Mellitus
Discrimination (Psychology)*
Echocardiography
Electrocardiography
Humans
Hypertension

Figure

• 

  Fig. 1 Echocardiographic measurements of AEMDs. (A) The time intervals, from the P wave initiation on the surface electrocardiogram channel to the initiation and peak of the late diastolic transmitral inflow on pulse wave Doppler images, were defined as the AEMDi and AEMDp. (B) The time intervals, from the P wave initiation on the surface electrocardiogram channel to the initiation and peak of the late diastolic lateral mitral annular motion on tissue Doppler images, were defined as the AEMDim and AEMDpm. AEMD: atrial electromechanical delay.

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