Advanced search
1 file | 222.12 KB

Transthoracic tissue Doppler imaging of the atria: a novel method to determine the atrial fibrillation cycle length

Author
Organization
Abstract
Background: The atrial fibrillation cycle length (AFCL) is a critical parameter for the perpetuation and termination of AF. In the present study, we evaluated a new method to measure the AFCL based on transthoracic tissue Doppler imaging (TDI) of the right atrium (RA) and left atrium (LA). Methods: Twenty patients with AF (6 acute AF, 14 persistent or permanent AF) were studied. A quadripolar catheter was positioned at RA or LA to measure AFCL (AFCL(EGM), gold standard). Transthoracic echocardiography (apical 4-chamber view) was used to perform pulsed wave TDI at the free wall of RA or LA. AFCL(TDI) was defined as the time interval between two consecutive positive to negative crossings of the baseline of the atrial time velocity curves. AFCL(EGM) and AFCL(TDI) were measured at baseline and during a 10-minute infusion of flecainide (1.5 mg/kg). Results: Measurement of AFCL(TDI) was feasible in all but one patient. At baseline, AFCL(EGM) was 170 +/- 22 ms, AFCL(TDI) 172 +/- 22 ms (difference 2 +/- 5 ms). AFCL(TDI) correlated significantly with AFCL(EGM) (R = 0.91, P < 0.0001). Bland-Altman analysis showed a bias of -2 ms with a 95% limit of agreement between -26 ms and +22 ms. During flecainide, the AFCL(TDI) method yielded an AFCL prolongation from 176 +/- 23 ms at baseline to 279 +/- 68 ms (P < 0.01) after 10 minutes of infusion (57 +/- 26%). Conclusions: (1) Tissue Doppler imaging of the atria during transthoracic echocardiography can be used to reliably determine the AFCL during both acute and persistent or permanent AF. (2) Continuous measurement of AFCL with TDI can be used to monitor the effect of antiarrhythmic drugs on atrial rate during AF. (3) This novel method is attractive because of the ease of acquiring the data and its noninvasive character.
Keywords
IBUTILIDE, PROCAINAMIDE, atrial fibrillation, electrophysiology, echocardiography, tissue Doppler imaging, SINUS RHYTHM, APPENDAGE FUNCTION, SURFACE ELECTROCARDIOGRAM, FREQUENCY-ANALYSIS, ECHOCARDIOGRAPHY, REFRACTORINESS, CARDIOVERSION, VERAPAMIL

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 222.12 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Duytschaever, Mattias, Alex Heyse, Johan De Sutter, Harry Crijns, Thierry Gillebert, René Tavernier, and Robert Tieleman. 2006. “Transthoracic Tissue Doppler Imaging of the Atria: a Novel Method to Determine the Atrial Fibrillation Cycle Length.” Journal of Cardiovascular Electrophysiology 17 (11): 1202–1209.
APA
Duytschaever, M., Heyse, A., De Sutter, J., Crijns, H., Gillebert, T., Tavernier, R., & Tieleman, R. (2006). Transthoracic tissue Doppler imaging of the atria: a novel method to determine the atrial fibrillation cycle length. JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 17(11), 1202–1209.
Vancouver
1.
Duytschaever M, Heyse A, De Sutter J, Crijns H, Gillebert T, Tavernier R, et al. Transthoracic tissue Doppler imaging of the atria: a novel method to determine the atrial fibrillation cycle length. JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. 2006;17(11):1202–9.
MLA
Duytschaever, Mattias, Alex Heyse, Johan De Sutter, et al. “Transthoracic Tissue Doppler Imaging of the Atria: a Novel Method to Determine the Atrial Fibrillation Cycle Length.” JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 17.11 (2006): 1202–1209. Print.
@article{356076,
  abstract     = {Background: The atrial fibrillation cycle length (AFCL) is a critical parameter for the perpetuation and termination of AF. In the present study, we evaluated a new method to measure the AFCL based on transthoracic tissue Doppler imaging (TDI) of the right atrium (RA) and left atrium (LA).
Methods: Twenty patients with AF (6 acute AF, 14 persistent or permanent AF) were studied. A quadripolar catheter was positioned at RA or LA to measure AFCL (AFCL(EGM), gold standard). Transthoracic echocardiography (apical 4-chamber view) was used to perform pulsed wave TDI at the free wall of RA or LA. AFCL(TDI) was defined as the time interval between two consecutive positive to negative crossings of the baseline of the atrial time velocity curves. AFCL(EGM) and AFCL(TDI) were measured at baseline and during a 10-minute infusion of flecainide (1.5 mg/kg).
Results: Measurement of AFCL(TDI) was feasible in all but one patient. At baseline, AFCL(EGM) was 170 +/- 22 ms, AFCL(TDI) 172 +/- 22 ms (difference 2 +/- 5 ms). AFCL(TDI) correlated significantly with AFCL(EGM) (R = 0.91, P < 0.0001). Bland-Altman analysis showed a bias of -2 ms with a 95% limit of agreement between -26 ms and +22 ms. During flecainide, the AFCL(TDI) method yielded an AFCL prolongation from 176 +/- 23 ms at baseline to 279 +/- 68 ms (P < 0.01) after 10 minutes of infusion (57 +/- 26%).
Conclusions: (1) Tissue Doppler imaging of the atria during transthoracic echocardiography can be used to reliably determine the AFCL during both acute and persistent or permanent AF. (2) Continuous measurement of AFCL with TDI can be used to monitor the effect of antiarrhythmic drugs on atrial rate during AF. (3) This novel method is attractive because of the ease of acquiring the data and its noninvasive character.},
  author       = {Duytschaever, Mattias and Heyse, Alex and De Sutter, Johan and Crijns, Harry and Gillebert, Thierry and Tavernier, René and Tieleman, Robert},
  issn         = {1045-3873},
  journal      = {JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY},
  keywords     = {IBUTILIDE,PROCAINAMIDE,atrial fibrillation,electrophysiology,echocardiography,tissue Doppler imaging,SINUS RHYTHM,APPENDAGE FUNCTION,SURFACE ELECTROCARDIOGRAM,FREQUENCY-ANALYSIS,ECHOCARDIOGRAPHY,REFRACTORINESS,CARDIOVERSION,VERAPAMIL},
  language     = {eng},
  number       = {11},
  pages        = {1202--1209},
  title        = {Transthoracic tissue Doppler imaging of the atria: a novel method to determine the atrial fibrillation cycle length},
  url          = {http://dx.doi.org/10.1111/j.1540-8167.2006.00604.x},
  volume       = {17},
  year         = {2006},
}

Altmetric
View in Altmetric
Web of Science
Times cited: