Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Right atrial conduction time for predicting coexistent typical atrial flutter in patients with paroxysmal atrial fibrillation.
Journal Formal name:Journal of cardiovascular electrophysiology
Abbreviation:J Cardiovasc Electrophysiol
ISSN code:10453873/15408167
Domestic / ForeginForegin
Publisher John Wiley & Sons, Inc.
Volume, Issue, Page press
Author and coauthor HIGUCHI Satoshi†, EJIMA Koichiro*, SHODA Morio, KANAI Miwa, KATAOKA Shohei, YAZAKI Kyoichiro, YAGISHITA Daigo, YOSHIDA Ayano, TANINO Sae, SAITO Chihiro, YAGISHITA Yoshimi, ARAI Kotaro, ASHIHARA Kyomi, HAGIWARA Nobuhisa
Publication date 2020/06
Summary INTRODUCTION:Screening of coexistent typical atrial flutter (AFL) in patients with atrial fibrillation (AF) is sometimes challenging. This study investigated whether a prolonged right atrial conduction time (RACT) estimated by tissue Doppler imaging (TDI) predicts patients with concomitant AFL and AF.METHODS AND RESULTS:We retrospectively analyzed 398 patients (mean age 61.6 years, 73.4% men) undergoing catheter ablation of paroxysmal AF. The patients were classified into 2 groups according to whether they had evidence of AFL (N=122, 30.7%) determined by a clinical observation (N=68), induction during procedures (N=33), or AFL recurrence after procedures (N=21) or not (N=276, 69.3%). The preoperative RACT, defined as a longer duration between the onset of the P-wave and peak A'-wave on the right atrial lateral wall or septal wall, and total atrial conduction time (TACT), defined as the same time duration on the left atrial lateral wall, were evaluated in all patients. Patients with evidence of AFL had a significantly longer RACT than those without AFL (p<0.001). A multiple logistic regression and receiver operator characteristics curve analysis revealed the ratio of the RACT and TACT (RACT/TACT) was the independent and most superior accurate cofounder for predicting evidence of AFL (area under the curve 0.867). When adding a discriminator of an RACT/TACT≧93% into the conventional screening, 98.4% of the patients with evidence of AFL were estimated to be treated during the initial procedures.CONCLUSION:The estimated RACT/TACT using the TDI may be useful for predicting patients with concomitant AFL in patients with AF. This article is protected by copyright. All rights reserved.
DOI 10.1111/jce.14623
PMID 32557919