title: Assessment of atrial regional wall motion using strain Doppler imaging during biatrial pacing in the bradycardia-tachycardia syndrome.
abstract: 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.
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University, Graduate School of Medicine, Yokohama, Japan. birth-45@fukuhp.yohohama-cu.ac.jp
authors.forename: Katsumi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sumita
authors.forename: Kohei
authors.initials: K
authors.lastname: Matsushita
authors.forename: Noriko
authors.initials: N
authors.lastname: Inoue
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: 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