Kosmala, W and Saito, M and Kaye, G and Negishi, K and Linker, N and Gammage, M and Marwick, TH, on behalf of the Protect-Pace Investigators, Incremental value of left atrial structural and functional characteristics for prediction of atrial fibrillation in patients receiving cardiac pacing, Circulation: Cardiovascular Imaging, 8, (4) Article e002942. ISSN 1941-9651 (2015) [Refereed Article]
Copyright 2015 American Heart Association, Inc.
Methods and Results: Clinical data were obtained prospectively in 146 enrollees (73 ± 10 years) undergoing dual chamber pacemaker implantation in the Protect-Pace study. Echocardiograms and 2-dimensional strain analysis were obtained post implantation and at 2 years. Complete ascertainment of AF during follow-up was identified from interrogation of permanent pacemakers. Cox regression was used to identify correlates of AF. Incident AF (n = 29, 20%) was associated with higher systolic blood pressure (P = 0.01), lower left ventricular ejection fraction (P = 0.03), lower LA strain at atrial contraction (LASac; P < 0.001), higher LAV (P<0.003), and longer septal electromechanical conduction time (P < 0.01). The associations of LAV and LASac with incident AF were independent of age, sex, systolic blood pressure, and left ventricular size and function. However, the combination of the 3 strongest predictors showed LASac (P = 0.02) and systolic blood pressure (P = 0.01) were independently associated with incident AF, but LAV was not (P = 0.07). Using the optimal cut points from receiver operator characteristic curves (62 mL for LAV and 8.6% for LASac), we demonstrated that a significantly greater rate of AF was associated with both lower LASac at higher LAV and with lower LASac at lower LAV.
Conclusions: The risk of AF in patients receiving dual chamber pacing is independently associated with LA size and function, not left ventricular structural and functional characteristics or right ventricular lead location.
|Item Type:||Refereed Article|
|Keywords:||atrial fibrillation, atrial strain, atrial volume, cardiac pacing, electromechanical conduction time|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|Author:||Kosmala, W (Professor Wojciech Kosmala)|
|Author:||Saito, M (Dr Makoto Saito)|
|Author:||Negishi, K (Dr Kazuaki Negishi)|
|Author:||Marwick, TH (Professor Tom Marwick)|
|Web of Science® Times Cited:||6|
|Deposited By:||Menzies Institute for Medical Research|
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