Abstract 6137: Atrial Tissue Doppler Imaging For Prediction Of New-Onset Atrial Fibrillation
The total atrial conduction time (TACT) is an independent predictor of atrial fibrillation (AF). Recently, we developed a new transthoracic echocardiographic tool to determine the TACT by means of tissue Doppler imaging (PA-tdi). We hypothesized that measurement of PA-tdi enables prediction of new-onset atrial fibrillation. We studied 249 patients without a history of AF. All patients underwent an echocardiogram and the PA-tdi interval was measured (the time from the initiation of the P-wave on the ECG (lead II) to the A′-wave on the lateral left atrial tissue Doppler tracing; (Figure⇓)). Patient characteristics and rhythm at follow-up were recorded. Fifteen patients (6%) developed new-onset AF during a mean follow-up duration of 698±274 days. These patients had a longer PA-tdi interval compared to patients who remained in sinus rhythm (172±25ms versus 150±20ms, P<0.001). Furthermore, the patients developing AF were older, more often had a history of heart failure or chronic obstructive pulmonary disease, used more often alpha-blockers, had enlarged left atria and more frequently mitral incompetence on the echocardiogram. After adjusting for potential confounders logistic regression showed that PA-tdi (OR: 1.532; 95%CI:1.108–2.118; P=0.01) was associated with new-onset AF. In patients with a prolonged PA-tdi interval (>165ms) 16% developed new-onset AF, compared to 3% in patients with a PA-tdi interval < 165ms (P=0.001). A prolonged PA-tdi interval may predict the development of new-onset AF. This parameter may be used to identify patients at risk in future strategies to prevent the development or complications of AF.