Assessment of atrial regional wall motion using strain Doppler imaging during biatrial pacing in the bradycardia-tachycardia syndrome.
BACKGROUND
Biatrial pacing is expected to have preventive effects on atrial fibrillation.


METHODS
We evaluated atrial regional wall motion by strain Doppler imaging (SDI) in 6 patients (62.5 +/- 11.3 [SD] years), who suffered from atrial fibrillation, with an implanted biatrial pacemaker. SDI was performed and atrial regional wall motion was estimated during biatrial (BiA) and right atrial appendage (RAA) pacing.


RESULTS
There was no significant difference in the interval from the pacing spike to the peak strain of the atrium in the lateral right atrium (LRA) between BiA and RAA pacing. However, there was a significant difference in the septal atrium (SA) between BiA and RAA pacing (225.0 +/- 19.9 vs 267.2 +/- 15.7 ms, P < 0.0001) and in the lateral left atrium (LLA) between BiA and RAA pacing (216.7 +/- 21.6 vs 275.0 +/- 16.2 ms, P < 0.0001). There were significant differences in the time difference of peak strain between BiA and RAA pacing in each atrial segment (LRA-AS: 2.2 +/- 5.9 vs 45.0 +/- 11.9 ms, P = 0.0016, SA-LLA: -8.3 +/- 5.5 vs 7.8 +/- 2.7 ms, P < 0.0011, LRA-LLA: -6.1 +/- 3.9 vs 52.8 +/- 13.2 ms, P = 0.0002). There was no significant difference in the interval from the pacing spike to the inflection point of atrial strain (S-I) of LRA. However, there were significant differences in S-I of SA (83.9 +/- 24.1 vs 129.9 +/- 30.6 ms, P = 0.0086) and LLA (102.2 +/- 37.9 vs 166.1 +/- 13.4 ms, P = 0.0028).


CONCLUSIONS
BiA pacing improved the synchronicity of regional wall motion of both atrium.
Matsumoto
Katsumi
K
Department of Medical Science and Cardiorenal Medicine, Yokohama City University, Graduate School of Medicine, Yokohama, Japan. birth-45@fukuhp.yohohama-cu.ac.jp
Ishikawa
Toshiyuki
T
Sumita
Shinichi
S
Matsushita
Kohei
K
Inoue
Noriko
N
Kobayashi
Tsukasa
T
Uchino
Kazuaki
K
Kimura
Kazuo
K
Umemura
Satoshi
S
D000328:Adult; D000368:Aged; D016275:Atrial Function; D001919:Bradycardia / Q000000981:diagnostic imaging* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D013610:Tachycardia / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome