title: Atrial fibrillatory wall motion and degree of atrial remodeling in patients with atrial fibrillation: a tissue velocity imaging study.
abstract: BACKGROUND
  The atrial fibrillation cycle length (AFCL) and the intracardiac atrial electrogram morphology may be used to characterize atrial fibrillation (AF). However, assessment of these parameters requires an invasive electrophysiological study. We assessed clinical and electrophysiological correlates of noninvasive tissue velocity imaging (TVI) of the right and left atrial myocardial fibrillatory wall motion.
  
  
  RESULTS
  We performed an electrophysiological study in 12 patients with AF referred for His bundle ablation. Using atrial electrograms, we determined the AFCL (AFCL-egm) and electrophysiological AF type. Simultaneously, transthoracic echocardiography was performed. We used the TVI traces to determine the cycle length of the atrial fibrillatory wall motion (AFCL-tvi) and atrial fibrillatory wall velocities (AFV-tvi). AFCL-tvi matched very well with AFCL-egm (r(2)= 0.98; P < 0.001), both in the left and right atrium. Patients with permanent AF had shorter AFCL-tvi (155 +/- 15 ms vs 216 +/- 23 ms; P < 0.001), higher AFCL-tvi variability, and lower AFV-tvi compared to patients with paroxysmal AF. Three electrophysiological AF types were found based on the morphology of the electrograms and these related to specific TVI patterns.
  
  
  CONCLUSIONS
  TVI of the atrial fibrillatory wall motion may enhance noninvasive characterization of atrial remodeling in patients with atrial fibrillation.
authors.affiliation: Department of Cardiology and CARIM, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands.
authors.forename: Cees B
authors.initials: CB
authors.lastname: De Vos
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.forename: Ron
authors.initials: R
authors.lastname: Pisters
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schotten
authors.forename: Emile C
authors.initials: EC
authors.lastname: Cheriex
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Tammo
authors.initials: T
authors.lastname: Delhaas
authors.forename: Harry J G M
authors.initials: HJ
authors.lastname: Crijns
authors.forename: Robert G
authors.initials: RG
authors.lastname: Tieleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009068:Movement