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The Relationship between Left Atrial Volume and Ventricular Arrhythmias in the Patients with Dilated Cardiomyopathy
Abdullah Kaplan1, Ahmet Gurdal1, Cansu Akdeniz1
1Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Insights
Left Atrial Volume (LAV) index is a significant predictor of malignant ventricular arrhythmias in patients with left ventricular dysfunction. Higher LAV index values indicate increased risk, aiding in identifying patients needing closer monitoring and intervention.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Left ventricular dysfunction is associated with increased risk of malignant ventricular arrhythmias.
- Left Atrial Volume (LAV) is a recognized marker of diastolic dysfunction.
- Implantable Cardioverter Defibrillator (ICD) devices are used to manage patients at risk for sudden cardiac death.
Purpose of the Study:
- To investigate the association between Left Atrial Volume (LAV) and LAV index with the incidence of malignant ventricular arrhythmias.
- To determine if LAV measurements can predict arrhythmia events in patients with left ventricular dysfunction and an ICD.
Main Methods:
- Cross-sectional study of 32 patients with dilated cardiomyopathy and an implanted ICD.
- Echocardiographic assessment including LAV and LAV index calculation.
- Statistical analysis using t-test, Mann-Whitney U test, and Pearson correlation (P < 0.05 significance).
Main Results:
- LAV index was significantly higher in patients with malignant ventricular arrhythmias (VT/VF) compared to those without (39.27 vs. 25.18 mL/m², P=0.004).
- Both LAV and LAV index were significantly greater in patients who received ICD shock therapy within the last year.
- No significant difference in LAV was observed between patients with and without arrhythmias (P=0.100).
Conclusions:
- LAV index is a valuable parameter for identifying patients at high risk of malignant ventricular arrhythmias.
- Elevated LAV and LAV index correlate with increased arrhythmia burden and ICD shocks.
- These findings suggest LAV index can aid in risk stratification for ventricular arrhythmias.
Background:
The present study aimed to investigate the relationship between Left Atrial Volume (LAV), a marker of diastolic dysfunction, and the frequency of malignant ventricular arrhythmia in the patients with left ventricular dysfunction and a previously implanted Implantable Cardioverter Defibrillator (ICD) device.
Methods:
This cross-sectional study was conducted on 32 patients with ischemic or idiopathic dilated cardiomyopathy, each having had an ICD device implanted at least 1 year beforehand. The ventricular arrhythmia episodes which were detected and stored by the device were retrieved and evaluated. In addition to routine echocardiographic measurements, all the patients had their LAV and LAV indexes calculated. After all, student's t-test, Mann-Whitney U test, and Pearson correlation were used to analyze the data. Besides, P value < 0.05 was considered as statistically significant.
Results:
This study was conducted on 4 female and 28 male patients with the mean age of 58.41 ± 9.97 years. Among the study patients, 21 had at least one previous myocardial infarction. In addition, 17 patients had experienced sustained VT or VF within the last year. No significant difference was found between the patients with and without malignant ventricular arrhythmias (sustained VT or VF) regarding LAV (17 patients with arrhythmia (68 + 23.39 mL) vs. 15 patients without arrhythmia (55.13 ± 20.41 mL); P = 0.100). However, the LAV index was significantly higher in the patients with arrhythmia compared to those without arrhythmia (39.27 ± 12.19 mL / m2 vs. 25.18 ± 7.45 mL / m2; P = 0.004). Both LAV (73.33 ± 17.64 mL and 57.52 ± 23.15 mL, respectively; P = 0.040) and LAV index (40.86 ± 8.47 mL / m2 and 28.20 ± 11.77 mL / m2, respectively; P = 0.010) were significantly greater in the patients with ICD shock therapy within the last year compared to the others. However, both groups were similar regarding Left Ventricular Volume (LVV), LVV index, and ejection fraction.
Conclusions:
The study findings demonstrated that LAV and LAV index could be used in detecting the patients who are at high risk of malignant ventricular arrhythmias.
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