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Clinical and echocardiographic correlates of intra-atrial conduction delay.
MedLine Citation:
PMID:  21846646     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims The total atrial conduction time (TACT) is an important electrophysiological parameter. We developed a new transthoracic echocardiographic tool (PA-TDI). The PA-TDI interval is a reflection of the TACT. In the present study, we evaluated the clinical and echocardiographic correlates of intra-atrial conduction delay. Methods and results We studied 427 patients without class I anti-arrhythmic agents or amiodarone. All patients underwent an echocardiogram and the PA-TDI interval was measured. Patient characteristics were recorded. The mean PA-TDI was 157 ± 22 ms. Multivariate linear regression analysis revealed that atrial fibrillation (AF) in history (B = 9.7; 95%CI 5.7-13.8; P< 0.001), hypertension (B = 5.5; 95%CI 1.4-9.8; P= 0.01), clinically relevant valve disease (B = 5.7; 95%CI 0.5-10.8; P= 0.03), age (B = 5; 95%CI 3.3-6.6; P< 0.001), and body mass index (BMI; B = 2.6; 95%CI 0.3-4.9; P= 0.026) were independently associated with the PA-TDI interval. On the echocardiogram: the aortic diameter (B = 0.7; 95%CI 0.2-1.2; P= 0.009), left atrial dimension (B = 0.9; 95%CI 0.5-1.3; P< 0.001), mitral valve E-wave deceleration time (B = 0.1; 95%CI 0.1-0.1; P< 0.001), aortic incompetence (B = 13; 95%CI 3.3-22.6; P= 0.008), and mitral incompetence (B = 11; 95%CI 3.6-17.5; P< 0.003) were independently associated with the PA-TDI interval. Conclusion This study is the largest to investigate the relation between the atrial conduction time, underlying heart diseases, and echocardiographic parameters. We found that the PA-TDI was independently prolonged in patients with a history of AF, hypertension, valve disease, higher age, and a higher BMI. Signs of diastolic dysfunction, valve incompetence, and enlarged atrium or aortic root on the echocardiogram were associated with a prolonged PA-TDI. This suggests that early and aggressive treatment of hypertension, diastolic dysfunction, and obesity could prevent intra-atrial conduction delay.
Authors:
Bob Weijs; Cees B de Vos; Robert G Tieleman; Ron Pisters; Emile C Cheriex; Martin H Prins; Harry J G M Crijns
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-15
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
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