In:
Echocardiography, Wiley, Vol. 31, No. 2 ( 2014-02), p. 140-148
Abstract:
A considerable number of patients with atrial fibrillation ( AF ) develop cardioembolic stroke ( CE ) despite low CHADS 2 score. We examined the possibility that use of the atrial electromechanical interval ( AEMI ) improves prediction of CE in patients with paroxysmal AF ( PAF ), particularly those with low CHADS 2 score. Methods We consecutively enrolled 108 patients with nonvalvular PAF and 52 healthy subjects as controls. The PAF patients were divided into 2 groups depending on presence (n = 36) or absence (n = 72) of the history of CE . Left atrial ( LA ) volume index ( LAVI ), peak myocardial velocity during late diastole (a'), and AEMI as time from onset of P‐wave to onset of lateral a' were measured. Results Patients with PAF had significantly larger LAVI , longer AEMI , and lower lateral a' than those in controls. Area under the curves for LAVI , lateral a', and AEMI for identifying patients with PAF were 0.70, 0.69, and 0.88, respectively. Multivariate logistic regression analysis indicated that age, use of antiarrhythmic drugs, and AEMI , but not LAVI or a', were independently associated with history of CE in patients with PAF . PAF patients were categorized into low risk by CHADS 2 score (i.e. CHADS 2 score = 0 or 1, n = 60), those with prolonged AEMI ( 〉 82 msec) had significantly higher rates of CE than those with ≤82 msec (48% vs. 15%, P 〈 0.05). Conclusion As compared with echocardiographic parameters of LA size and LA function, AEMI appears to be more useful for identifying PAF patients. AEMI may enable to detect high risk PAF patients, especially those categorized into low risk by CHADS 2 score.
Type of Medium:
Online Resource
ISSN:
0742-2822
,
1540-8175
DOI:
10.1111/echo.2014.31.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2041033-5
Bookmarklink