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Prolonged atrium electromechanical interval is associated with stroke in patients with atrial fibrillation after

Tze-Fan Chao1, Yenn-Jiang Lin, Hsuan-Ming Tsao

  • 1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Journal of Cardiovascular Electrophysiology
|December 21, 2012
PubMed

Insights

The atrial electromechanical interval (PA-PDI) can identify patients at high risk of stroke after atrial fibrillation (AF) catheter ablation. A longer PA-PDI interval after ablation predicts future ischemic strokes, aiding risk stratification.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Stroke Prevention

Background:

  • Atrial fibrillation (AF) significantly increases stroke risk.
  • Catheter ablation is an effective treatment for symptomatic, drug-refractory AF.
  • Identifying post-ablation stroke risk is crucial for patient management.

Purpose of the Study:

  • To evaluate the atrial electromechanical interval (PA-PDI) as a predictor of stroke risk.
  • To determine if PA-PDI can identify patients at high risk after successful AF ablation.

Main Methods:

  • 279 AF patients undergoing catheter ablation without recurrence were studied.
  • The post-ablation PA-PDI was measured using Doppler imaging.
  • Patients were followed for ischemic stroke occurrence.

Main Results:

  • Patients who suffered strokes had significantly longer PA-PDI intervals (161.2 ± 7.7 ms vs 138.7 ± 12.4 ms).
  • A PA-PDI cutoff of 150 ms showed 86.7% positive and 100% negative predictive values for stroke.
  • PA-PDI improved stroke prediction accuracy when combined with CHA2DS2-VASc score (AUC increased from 0.75 to 0.85).

Conclusions:

  • The PA-PDI interval is a valuable tool for identifying stroke risk in AF patients post-ablation.
  • This measurement aids in refining risk stratification beyond traditional scores.
Abstract

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