Naslov
Atrial Velocity and Deformation as Markers of Atrial Mechanical Transport Following Atrial Fibrillation Surgery Using Transesophageal Doppler Myocardial Imaging

Autori
Gašparović, Hrvoje ; Čikeš, Maja ; Kopjar, Tomislav ; Velagić, Vedran ; Miličić, Davor ; Biočina, Bojan ; Bijnens, Bart

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
The Heart Surgery Forum / Levinson, Mark M - , 2011

Skup
21st World Congress of The World Society Of Cardio-Thoracic Surgeons

Mjesto i datum
Berlin, Njemačka, 12.06.2011. - 15.06.2011

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
atrial fibrillation; atrial transport function; radiofrequency ablation for atriall fibrillation; strain rate; tissue velocity imaging

Sažetak
Objective: Controversy surrounds the issue of atrial transport following the restitution of sinus rhythm (SR) after permanent atrial fibrillation (AF). Postoperative spontaneous restitution of SR occurs briefly in many patients with AF. We aimed to determine whether postoperative conversion of AF to SR leads to restoration of atrial contractility, and whether radiofrequency ablation (RFA) independently impacted atrial function. Methods: We evaluated 24 patients with permanent AF. Twelve patients (64 ± 9 years, EuroSCORE 5 ± 5) underwent a biatrial MAZE procedure. Twelve patients with permanent AF (69 ± S years, EuroSCORE 8 ± 6) who were briefly in SR intraoperatively, but did not undergo any atrial fibrillation surgery, comprised fhe non-RFA group. Tissue Doppler myocardial imaging was performed pre- and post-surgical intervention. Tissue velocity (TVI) and strain rate (SRI) data were acquired at the left atrial lateral wall. Results: Baseline ECG demonstrated preoperative IF and post- procedural SR in all studied patients. Postoperative atrial contraction was restored in both groups. Within the RFA group, postprocedural TVI values were lower during ventricular systole compared to preprocedural values (-2.1 ± 2.2 versus -4.1 ± 2.3, P = .03). Such changes were not noted in the non-RFA group. Conversely, the late diastolic postprocedural SRI was higher in the RFA group than in the non-RFA group (-1.4 ± 1.2 versus -0.6 ± 0.6, P=.04). Observed TVI and SRI values were lower than reported normal value. Conclusion: Coordinated atrial activation with induction of atrial contraction occurs with low velocity and deformation both in patients with and without atrial fibrillation surgery. Atrial electrical activation is, therefore, not synonymous with normal atrial contraction. RFA does not further reduce the atrial contractile capacity in comparison to the atria that have spontaneously converted into SR. Conversely, patients in the RFA group had modestly superior late diastolic tissue Doppler imaging profiles. Impairment in atrial reservoir function post-RFA, likely due to ablation induced reduction in tissue compliance, was shown.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA