Electromechanical Abnormalities in Patients with Paroxysmal Atrial Fibrillation

Background: The loss of effective atrial contraction is associated with an increased thromboembolic risk. Aim: To study the electromechanical coupling of the atria in patients with paroxysmal atrial fibrillation (time of occurrence of the episodes <48 hours) using pulsed-wave tissue Doppler imaging. Materials and methods: The study included 51 patients (26 men, 25 women; mean age 59.84±1.60 years) and 52 controls (26 men, 26 women; 59.50±1.46 years) without evidence to date for episodes of atrial fibrillation. We studied atrial electromechanical delay in lateral mitral annulus (P-A'MV) (ms) and tricuspid annulus (P-A'TV) (ms) as well as interatrial dyssynchrony (IAD) ((P-A'MV) (P-A'TV)) (ms). The echocardiographic study in patients was performed on the twenty fourth hour and twenty-eighth day after the restoration of sinus rhythm. In controls the echocardiographic indicators were defined once. Results: PA'MV in patients with PAF was significantly prolonged compared to controls on the twenty-fourth hour as well as twentyeighth day after the restoration of sinus rhythm (124.7±5.54 vs 106.80±2.30 ms, p=0.002; 123.2±6.12 vs 106.80±2.30 ms, p=0.006 respectively). The measurement of PA'TV showed no difference in the indicator in patients and controls (91.24±4.79 vs 87.64±1.85 ms, p=0.44; 91.70±4.92 vs 87.64±1.85 ms, p=0.38 respectively). There is an increased IAD in patients with PAF compared to controls in both measurements (31.63±3.57 vs 18.64±1.35 ms, p<0.001; 31.55±2.75 vs 18.64±1.35 ms, p<0.001). Conclusion: Our study found prolonged atrial electromechanical delay and interatrial dyssynchrony after manifestation of PAF. The short episodes of arrhythmia lead to impaired electromechanical coupling for a long period of time. In this sense AF paroxysms are a major prerequisite for relapses of the disease and significantly increase the risk of embologenic accidents.