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Updated: Jun 28, 2025
08:10
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Determining The Risk of Atrial Fibrillation Paroxysm in Patients With Chronic Heart Failure With Intact and Reduced
I P Zakharov1, P Sh Chomakhidze1, F Yu Kopylov1
1Sechenov First Moscow State Medical University.
Kardiologiia
|April 10, 2024
Summary
Patients with chronic heart failure (CHF) have a high risk of developing paroxysmal atrial fibrillation (pAF), often without symptoms. Echocardiography (EchoCG) assessing left atrial ejection fraction (LA EF) and global strain (LA GS), along with remote monitoring, can aid early detection.
Area of Science:
- Cardiology
- Echocardiography
- Electrophysiology
Background:
- Chronic heart failure (CHF) is associated with an increased risk of atrial fibrillation (AF).
- Predicting AF development in CHF patients requires advanced diagnostic tools beyond standard assessments.
- Understanding predictors is crucial for timely intervention and management.
Purpose of the Study:
- To identify echocardiographic predictors of new-onset AF in patients with CHF.
- To evaluate the efficacy of extended echocardiography protocols, including diastolic function and left atrial strain, in predicting AF.
- To assess the utility of remote monitoring devices for detecting AF in this population.
Main Methods:
- 168 patients with CHF (stage I-III) and no prior AF history were analyzed.
- Extended echocardiography (EchoCG) included assessment of diastolic dysfunction, left atrial ejection fraction (LA EF), and left atrial global strain (LA GS).
- Patients underwent Holter ECG monitoring (HM ECG) and 7-day telemedicine monitoring; follow-up was 3 months or until AF detection.
Main Results:
- Paroxysmal AF (pAF) developed in 24.4% of patients; 75% of AF episodes were asymptomatic.
- CardioQVARK® remote monitoring detected pAF more effectively than HM ECG or 12-lead ECG.
- Significant predictors for AF included LA EF <36% (OR 1.04), LA GS <9.9% (OR 1.16), and TDI E med <5.7 cm/s (OR 0.97).
Conclusions:
- CHF patients face a substantial risk of developing pAF, frequently asymptomatic.
- EchoCG with LA EF, TDI E med, and LA GS assessment is recommended for identifying high-risk patients.
- Remote monitoring with devices like CardioQVARK® offers reliable early detection of pAF in CHF, enabling timely anticoagulant therapy.
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