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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Electro-Mechanical Alterations in Atrial Fibrillation: Structural, Electrical, and Functional Correlates

Iraklis Pozios1, Apostolos Ilias Vouliotis1, Polychronis Dilaveris1

  • 11st Department of Cardiology, Hippokration Hospital, School of Medicine, National & Kapodistrian University of Athens, 11527 Athens, Greece.

Journal of Cardiovascular Development and Disease
|April 27, 2023
PubMed

Insights

Atrial fibrillation, a common heart rhythm disorder, is linked to atrial myocardial structural remodeling. Echocardiography-derived total atrial conduction time may reflect these electrical and structural changes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Atrial fibrillation (AF) is the most prevalent arrhythmia, impacting patient survival and well-being.
  • Cardiovascular risk factors and aging contribute to atrial myocardial structural remodeling, a key driver of AF.
  • Structural remodeling encompasses atrial fibrosis, altered size, and cellular changes like myolysis and glycogen accumulation.

Purpose of the Study:

  • To explore the relationship between atrial myocardial structural remodeling and atrial fibrillation.
  • To investigate the electrical and functional correlates of conduction disturbances in the atria.
  • To evaluate the utility of echocardiography-derived total atrial conduction time in reflecting atrial alterations.

Main Methods:

  • Review of existing literature on atrial fibrillation pathophysiology and cardiac remodeling.
  • Analysis of electrical correlates, including P wave parameters and electrophysiological mapping.
  • Assessment of functional correlates using echocardiography and cardiac magnetic resonance imaging (MRI).

Main Results:

  • Structural remodeling, including fibrosis and cellular changes, is associated with interatrial block.
  • Conduction disturbances manifest as altered P wave parameters and abnormal electrophysiological characteristics.
  • Echocardiography-derived total atrial conduction time (PA-TDI duration) shows potential to reflect both electrical and structural atrial alterations.

Conclusions:

  • Atrial myocardial structural remodeling is a significant factor in the development of atrial fibrillation.
  • Interatrial block and prolonged conduction times are key electrical manifestations of these structural changes.
  • Echocardiography-derived total atrial conduction time offers a potential non-invasive marker for assessing atrial remodeling in AF.

Keywords:
ConnexinsP wave parametersatrial conductionatrial dilatationfibrosisinteratrial blockstructural remodelingtotal atrial conduction timevoltage mapping

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