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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Electrocardiographic and Echocardiographic Predictors of Atrial Fibrillation in Patients With Hypertrophic

Leonard Mandeş1,2, Monica Roşca1,2, Daniela Ciupercă1

  • 1Cardiology Department, University of Medicine and Pharmacy "Carol Davila"- Euroecolab, Bucharest, Romania.

Frontiers in Cardiovascular Medicine
|June 17, 2022
PubMed

Insights

Hypertrophic cardiomyopathy patients at risk for atrial fibrillation can be identified by left atrial booster pump function (ASr) and electrical dispersion (P wave dispersion - Pd). These measures predict AF incidence, even when left atrial size appears normal.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) patients exhibit a higher prevalence of atrial fibrillation (AF) than the general population.
  • Left atrial (LA) remodeling is a known risk factor for AF development in HCM.
  • Assessing LA structure and function is crucial for predicting AF risk in HCM.

Purpose of the Study:

  • To evaluate the predictive value of LA electrocardiographic and echocardiographic parameters for incident AF in HCM patients.
  • To determine if LA functional and electrical parameters are superior to structural parameters in predicting AF risk.

Main Methods:

  • Prospective, monocentric study of 126 HCM patients in sinus rhythm.
  • Median follow-up of 56 months, with AF incidence recorded.
  • Multivariable analysis including LA booster pump function (ASr), P wave dispersion (Pd), LA diameter, and LA volume.

Main Results:

  • 30.9% of patients developed new-onset AF during follow-up.
  • LA booster pump function (ASr) and P wave dispersion (Pd) were independent predictors of incident AF.
  • LA structural parameters (diameter, volume) did not predict AF, even in patients with small LA size (<45 mm).
  • P wave dispersion (Pd) accurately predicted AF in patients with small LA size (AUC = 0.89).

Conclusions:

  • LA booster pump function (ASr) and electrical dispersion (Pd) are key predictors of incident AF in HCM patients.
  • These parameters offer improved risk stratification for AF, particularly in patients with normal LA dimensions.
  • Electrical dispersion (Pd) is a valuable tool for identifying AF risk in HCM patients with small LA size.
Abstract

Keywords:
atrial fibrillationechocardiographyelectrocardiographyhypertrophic cardiomyopathyprognosis

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