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Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(8): 572-578 | DOI: 10.5152/AnatolJCardiol.2015.6424  

Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation

Nermin Bayar1, Çağın Mustafa Üreyen1, Zehra Erkal1, Selçuk Küçükseymen1, Serkan Çay2, Göksel Çağırcı1, Şakir Arslan1
1Department Of Cardiology, Antalya Education And Research Hospital, Antalya- Turkey
2Department Of Cardiology, Yüksek İhtisas Education And Research Hospital, Ankara- Turkey

Objective: This study aimed to evaluate the association between the history of stroke/transient ischemic attack (TIA) and inter- and intra-atrial electromechanical delay (EMD) in patients with paroxysmal atrial fibrillation (PAF).
Methods: Patients diagnosed with PAF were included in this retrospective study. Patients who had a history of stroke or TIA were defined as the symptomatic group, whereas those who did not have such a history were defined as the asymptomatic group. On the basis of the transthoracic echocardiographic records, atrial electromechanical coupling (time interval from the onset of the P wave on the surface electrocardiogram to the beginning of the A′ wave interval with tissue Doppler echocardiography) and intra- and interatrial EMD were measured.
Results: In this study, 160 patients were included, 52 of whom were symptomatic. While the intra-left atrial EMD was 68.2±6.1 ms in the symptomatic group, it was found to be 50.8±6.5 ms in the asymptomatic group (p<0.001). Interatrial EMD was 91.3±5.0 ms in the symptomatic group, whereas it was 71.5±7.0 ms in the asymptomatic group (p<0.001). In multiple logistic regression analysis, intra-left atrial [odds ratio (OR): 1.417, 95% confidence interval (CI): 1.193–1.684, p<0.001] and interatrial EMDs (OR: 1.398, 95% CI: 1.177–1.661, p<0.001) were found to be independently associated with the presence of stroke/TIA.
Conclusion: Prolonged inter- and intra-left atrial EMDs in patients with PAF is associated with stroke/TIA. Evaluating this parameter in addition to the CHA2DS2-VASc score in patients with PAF may be helpful in identifying patients who are at a high risk of stroke/TIA. (Anatol J Cardiol 2016; 16: 000-00)

Keywords: atrial fibrillation, stroke, electromechanical delay


Nermin Bayar, Çağın Mustafa Üreyen, Zehra Erkal, Selçuk Küçükseymen, Serkan Çay, Göksel Çağırcı, Şakir Arslan. Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation. Anatol J Cardiol. 2016; 16(8): 572-578

Corresponding Author: Nermin Bayar, Türkiye


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