Related Experiment Video
Updated: May 5, 2026
08:10
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
2.8K
Left atrial structure and function in atrial fibrillation: ENGAGE AF-TIMI 48
Deepak K Gupta1, Amil M Shah1, Robert P Giugliano2
1Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
European Heart Journal
|December 5, 2013
Summary
Left atrial (LA) structure and function worsen with increased atrial fibrillation (AF) burden and stroke risk. LA dysfunction occurs even with normal LA size and sinus rhythm, indicating LA function assessment is crucial for AF patients.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- The relationship between left atrial (LA) structure, function, atrial fibrillation (AF) burden, and stroke risk is complex and not fully understood.
- Atrial fibrillation (AF) is a common arrhythmia associated with increased stroke risk.
- Understanding LA remodeling in AF is crucial for risk stratification and management.
Purpose of the Study:
- To describe left atrial (LA) structure and function in patients with atrial fibrillation (AF).
- To investigate the association between LA structure/function and AF type and stroke risk (CHADS2 score).
Main Methods:
- Echocardiographic assessment of LA structure and function in 971 subjects from the ENGAGE AF-TIMI 48 trial.
- Comparison of LA size, emptying fraction (LAEF), and contractile function across different AF types (paroxysmal, persistent, permanent) and CHADS2 scores.
- Analysis of LA function in relation to LA size and heart rhythm (sinus rhythm vs. AF).
Main Results:
- The majority of AF patients (55%) exhibited both LA enlargement and reduced LA emptying fraction (LAEF), with an inverse correlation between LA size and LAEF (R = -0.57, P < 0.001).
- Increasing AF burden and higher CHADS2 scores were associated with increased LA size and decreased LAEF.
- A significant proportion of AF subjects (19%) had impaired LAEF despite normal LA size, and LA contractile dysfunction was observed even in those in sinus rhythm during echocardiography.
Conclusions:
- In a contemporary AF population, LA structure and function abnormalities correlate with increased AF electrical burden and stroke risk (CHADS2 score).
- LA dysfunction is present even with normal LA size and in sinus rhythm, suggesting LA function assessment provides valuable incremental information for AF patient evaluation.
- These findings highlight the importance of assessing LA function beyond LA size for comprehensive risk stratification in AF patients.
More Related Videos
Related Concept Videos
01:16Chambers of the Heart
10.0K
The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
Deoxygenated blood from the body is received in the right...
Deoxygenated blood from the body is received in the right...
10.0K
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
1.2K
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
1.2K
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
788
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
788
01:29Disturbances in Heart Rhythm
5.3K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
5.3K
01:28Dysrhythmias II: Classification of Tachyarrhythmias
735
Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
735