Background: The aim of this study was to investigate whether total atrial conduction time (TACT) assessed via tissue Doppler imaging (PA-TDI interval) can identify patients with early recurrent atrial fibrillation (ERAF) after successful direct-current electrical cardioversion (CV) of persistent atrial fibrillation (persPAF).
Methods And Results: A total of 54 patients without antiarrhythmic drug medication (mean ± SD: 66 ± 10.4 years; 33% women) with persPAF and successful CV were enrolled between May 2012 and May 2013. TACT was measured 6 hours after successful CV in the left atrium by tissue Doppler imaging (PA-TDI interval). ERAF was determined via Holter-electrocardiogram over a period of 7 days after CV. Receiver opearting characteristic analysis was used to determine an optimal cutoff value of PA-TDI interval for prognosis of ERAF. Based on this result, recurrence-free survival was assessed with Mantel-Haenszel's log-rank test. ERAF occurred in 23 patients (43%). PA-TDI interval was longer in patients with ERAF compared to those who maintained sinus rhythm (mean ± SD: 163.5 ± 11.1 vs 132.3 ± 11.2 milliseconds; P < 0.00001). At the cutoff value of 152 milliseconds, PA-TDI interval sensitivity and specificity related to ERAF were 87% and 100%, respectively.
Conclusion: Measuring PA-TDI interval may help to predict ERAF after successful CV in patients with persAF.
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Article Synopsis
- The study investigates the time from the P-wave on an ECG to the peak A' velocity of the left atrial wall, known as the PA-TDI interval, which reflects total atrial conduction time (TACT) and can indicate atrial issues.
- Researchers analyzed 62 patients with atrioventricular nodal reentrant tachycardia (AVNRT) and 42 control subjects, using an ajmaline challenge test alongside tissue Doppler imaging for their assessments.
- Results showed that the PA-TDI interval was significantly longer in AVNRT patients (both with and without drug-induced type 1 Brugada pattern) compared to controls, indicating that TACT is altered in those with AVNRT.
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