Association between interatrial block, left atrial fibrosis, and mechanical dyssynchrony: Electrocardiography‐magnetic resonance imaging correlation.

Introduction: Advanced interatrial block (IAB) on a 12‐lead electrocardiogram (ECG) is a predictor of stroke, incident atrial fibrillation (AF), and AF recurrence after catheter ablation. The objective of this study was to determine which features of IAB structural remodeling is associated with left...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 31; no. 7; pp. 1719 - 1726
Autores principales: Ciuffo, Luisa, Bruña, Vanesa, Martínez‐Sellés, Manuel, Vasconcellos, Henrique Doria, Tao, Susumu, Zghaib, Tarek, Nazarian, Saman, Spragg, David D., Marine, Joseph, Berger, Ronald D., Lima, Joao A. C., Calkins, Hugh, Bayés‐de‐Luna, Antonio, Ashikaga, Hiroshi
Formato: diagnostic images research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Jul2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2020
      vid: 31
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.14608
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        atl: Association between interatrial block, left atrial fibrosis, and mechanical dyssynchrony: Electrocardiography‐magnetic resonance imaging correlation.
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          Ciuffo, Luisa
          Bruña, Vanesa
          Martínez‐Sellés, Manuel
          Vasconcellos, Henrique Doria
          Tao, Susumu
          Zghaib, Tarek
          Nazarian, Saman
          Spragg, David D.
          Marine, Joseph
          Berger, Ronald D.
          Lima, Joao A. C.
          Calkins, Hugh
          Bayés‐de‐Luna, Antonio
          Ashikaga, Hiroshi
        affil: Division of Internal Medicine, University of New Mexico, Albuquerque New Mexico
      sug:
        subj:
          Heart Block
          Heart Atrium, Left
          Fibrosis
          Ventricular Remodeling Diagnosis
          Magnetic Resonance Imaging
          Electrocardiography
          Human
          Atrial Fibrillation Therapy
          Catheter Ablation
          Middle Age
          Aged
          Female
          Male
          Descriptive Statistics
          Stroke Volume
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Introduction: Advanced interatrial block (IAB) on a 12‐lead electrocardiogram (ECG) is a predictor of stroke, incident atrial fibrillation (AF), and AF recurrence after catheter ablation. The objective of this study was to determine which features of IAB structural remodeling is associated with left atrium (LA) magnetic resonance imaging structure and function. Methods/Results: We included 152 consecutive patients (23% nonparoxysmal AF) who underwent preprocedural ECG and cardiac magnetic resonance (CMR) in sinus rhythm before catheter ablation of AF. IAB was defined as P‐wave duration ≥120 ms, and was considered partial if P‐wave was positive and advanced if P‐wave had a biphasic morphology in inferior leads. From cine CMR and late gadolinium enhancement, we derived LA maximum and minimum volume indices, strain, LA fibrosis, and LA dyssynchrony. A total of 77 patients (50.7% paroxysmal) had normal P‐wave, 52 (34.2%) partial IAB, and 23 (15.1%) advanced IAB. Patients with advanced IAB had significantly higher LA minimum volume index (25.7 vs 19.9 mL/m2, P =.010), more LA fibrosis (21.9% vs 13.1%, P =.020), and lower LA maximum strain rate (0.99 vs 1.18, P =.007) than those without. Advanced IAB was independently associated with LA (minimum [P =.032] and fibrosis [P =.009]). P‐wave duration was also independently associated with LA fibrosis (β =.33; P =.049) and LA mechanical dyssynchrony (β = 2.01; P =.007). Conclusion: Advanced IAB is associated with larger LA volumes, lower emptying fraction, and more fibrosis. Longer P‐wave duration is also associated with more LA fibrosis and higher LA mechanical dyssynchrony.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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