Mechanical and substrate abnormalities of the left atrium assessed by 3-dimensional speckle-tracking echocardiography and electroanatomic mapping system in patients with paroxysmal atrial fibrillation

Background Left atrial (LA) remodeling progresses to electrical remodeling, contractile remodeling, and subsequently structural remodeling. Little is known about the relationship between LA electrical and anatomical remodeling and LA mechanical function. Objectives We aimed to clarify the relationsh...

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Veröffentlicht in:	Heart rhythm 2015-03, Vol.12 (3), p.490-497
Hauptverfasser:	Watanabe, Yoshikazu, MD, Nakano, Yukiko, MD, PhD, Hidaka, Takayuki, MD, PhD, Oda, Noboru, MD, PhD, Kajihara, Kenta, MD, PhD, Tokuyama, Takehito, MD, PhD, Uchimura, Yuko, MD, Sairaku, Akinori, MD, Motoda, Chikaaki, MD, Fujiwara, Mai, MD, PhD, Kawazoe, Hiroshi, MD, Matsumura, Hiroya, MD, Kihara, Yasuki, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Atrial fibrillation Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Atrial Function, Left Cardiovascular Catheter Ablation - methods Conduction delay Dyssynchrony Echocardiography, Three-Dimensional - methods Electroanatomic mapping Electrocardiography - methods Electrophysiologic Techniques, Cardiac - methods Female Heart Atria - diagnostic imaging Heart Atria - physiopathology Heart Conduction System Humans Left atrium Male Middle Aged Pulmonary Veins - surgery Remodeling Speckle-tracking echocardiography
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Zusammenfassung:	Background Left atrial (LA) remodeling progresses to electrical remodeling, contractile remodeling, and subsequently structural remodeling. Little is known about the relationship between LA electrical and anatomical remodeling and LA mechanical function. Objectives We aimed to clarify the relationship between LA mechanical function using 3-dimensional speckle-tracking echocardiography (3D-STE) and LA electrical remodeling using an electroanatomic mapping system (CARTO 3) and to estimate atrial fibrillation (AF) substrate in patients with paroxysmal AF (PAF). Methods A total of 52 patients with PAF (41 (79%) men; mean age 61 ± 11 years) undergoing their initial pulmonary vein isolation (PVI) were examined. The standard deviation of the time to peak strain in each LA segment (%SD-TPS) was analyzed as an index of LA dyssynchrony using 3D-STE before PVI. Contact LA bipolar voltage and activation maps were constructed during sinus rhythm before PVI using CARTO 3. The LA total activation time was measured and low-voltage zones (LVZs) were determined with a local bipolar electrogram amplitude of
ISSN:	1547-5271 1556-3871
DOI:	10.1016/j.hrthm.2014.12.007