Premium
Clinical Utility of Atrial Electromechanical Conduction Time Measured with Speckle Tracking Echocardiography after Catheter Ablation in Patients with Atrial Fibrillation: A Validation Study with Electroanatomical Mapping
Author(s) -
Fujii Akira,
Inoue Katsuji,
Nagai Takayuki,
Nishimura Kazuhisa,
Uetani Teruyoshi,
Suzuki Jun,
Funada Junichi,
Okura Takafumi,
Higaki Jitsuo,
Ogimoto Akiyoshi
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13259
Subject(s) - cardiology , medicine , atrial fibrillation , ejection fraction , catheter ablation , speckle tracking echocardiography , ablation , pulmonary vein , heart failure
Purpose Our recent report demonstrated that atrial electromechanical conduction time ( EMT ‐ε) measured with speckle tracking echocardiography could predict cardiac events in patients with pathological left ventricular hypertrophy. This study aimed to validate EMT ‐ε by comparison with electroanatomical mapping and to investigate the clinical utility of EMT ‐ε in patients with atrial fibrillation ( AF ) undergoing catheter ablation. Methods Forty‐six patients with preserved LV ejection fraction ( LVEF ≥ 50%) undergoing pulmonary vein isolation ( PVI ) for AF were studied. Atrial electrical conduction delay was determined by measuring atrial electrical activation time ( EAT ) using three‐dimensional electroanatomical mapping just after PVI . Echocardiographic parameters were acquired within 24 hours and at 6 months after PVI . The study also included 10 control subjects. Results AF patients had a larger left atrial ( LA ) volume index ( LAVI ) and more prolonged EMT ‐ε compared with control subjects. According to the validation study, EAT was closely related to EMT ‐ε and a′, and this association was independent of LAVI and the presence of persistent AF ( EMT ‐ε: R 2 = 0.342, P < 0.0001, a′: R 2 = 0.337, P < 0.0001). At 6 months after PVI , LAVI and EMT ‐ε were significantly improved. During continued follow‐up beyond 6 months (total follow‐up, 26 ± 12 months), the EMT ‐ε shortening at 6 months after PVI was significantly greater in AF ‐free patients than patients with AF recurrence. Conclusions: This study suggested that the EMT ‐ε could be a useful echocardiographic marker of LA electromechanical abnormalities in patients with AF .