Total Atrial Conduction Time as a Predictor of Left Atrial Functional Recovery in Atrial Fibrillation

JACC advances Pub Date : 2025-09-16 DOI:10.1016/j.jacadv.2025.102151

Hikari Seki MD , Koki Nakanishi MD , Masao Daimon MD , Kazutoshi Hirose MD , Kentaro Iwama MD , Yasuhiro Mukai MD , Yuriko Yoshida MD , Yuko Yamamoto MD , Megumi Hirokawa MD , Tomoko Nakao MD , Tsukasa Oshima MD , Takumi Matsubara MD , Yu Shimizu MD , Gaku Oguri MD , Toshiya Kojima MD , Eriko Hasumi MD , Katsuhito Fujiu MD , Hiroyuki Morita MD , Makoto Kurano MD , Norihiko Takeda MD

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引用次数: 0

Abstract

Background

Catheter ablation (CA) leads to the recovery of left atrial (LA) function in patients with atrial fibrillation (AF), although the degree varies substantially among individuals. PA-TDI duration, the time delay between the P-wave on the electrocardiogram to the peak A'-wave on tissue-Doppler imaging of the lateral LA wall is an echocardiographic measure that reflects structural and electrical LA remodeling.

Objectives

The objective of the study was to investigate whether the preprocedural PA-TDI duration could predict LA functional recovery after CA.

Methods

We studied 109 AF patients in sinus rhythm at preprocedural echocardiography, who underwent their first CA. PA-TDI duration was measured by tissue Doppler imaging from the apical four-chamber view. Speckle-tracking echocardiography was performed before and 6 months after CA to evaluate LA reservoir strain (LARS).

Results

The median (25th–75th percentile) PA-TDI duration was 144 (128-162) ms. There was no significant difference in age, sex, and AF risk factors between patients with longer PA-TDI duration (≥144 ms) and those with shorter PA-TDI duration (<144 ms). The median follow-up was 465 (273-746) days. LARS was significantly improved at 6 months after CA (29.7% ± 7.9% to 32.1% ± 6.7%; P < 0.001). Preprocedural PA-TDI duration was significantly associated with LARS at 6 months after CA independent of AF type, baseline LARS, and recurrent AF (standardized beta −0.20; 95% CI: −0.10 to −0.01; P = 0.013). Combination of baseline LARS and PA-TDI duration provided enhanced predictive value for postprocedural LA function (P < 0.001).

Conclusions

The measurement of PA-TDI duration provided valuable information for LA functional recovery in AF patients who underwent CA.

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心房总传导时间作为心房颤动左房功能恢复的预测因子。

背景：导管消融（CA）导致心房颤动（AF）患者左房（LA）功能的恢复，尽管个体之间的程度差异很大。PA-TDI持续时间，即心电图p波到LA侧壁组织多普勒成像A'波峰值之间的时间延迟，是反映LA结构和电重构的超声心动图指标。目的：探讨术前PA-TDI持续时间是否能预测CA后LA功能恢复。方法：对109例首次CA的房颤患者进行术前超声心动图窦性心律检查，采用组织多普勒心尖四室图测量PA-TDI持续时间。在CA前和CA后6个月进行斑点跟踪超声心动图评估LA储层应变（LARS）。结果：PA-TDI持续时间的中位数（25 -75个百分点）为144 (128-162)ms。PA-TDI持续时间较长的患者（≥144 ms）和PA-TDI持续时间较短的患者在年龄、性别和房颤危险因素方面无显著差异(结论：PA-TDI持续时间的测量为房颤患者行CA后LA功能恢复提供了有价值的信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC advances Cardiology and Cardiovascular Medicine

CiteScore

1.90

自引率

0.00%

发文量