title: Associations between the atrial electromechanical interval, atrial remodelling and outcome of catheter ablation in paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  The atrial electromechanical (PA-PDI) interval was reported to be a useful predictor of new-onset atrial fibrillation (AF) and the occurrence of AF after coronary artery bypass surgery. The aim of this study was to investigate the associations of the electromechanical interval with atrial substrate properties and the outcome of catheter ablation in paroxysmal AF patients.
  
  
  METHODS
  132 paroxysmal AF patients who had received catheter ablation were enrolled. The electromechanical interval was determined as the time interval from the initiation of P-wave deflection to the peak of the mitral inflow A-wave on pulse-wave Doppler imaging. The left atrial voltage and total activation time were collected before pulmonary vein isolation. Every patient underwent standard follow-up after catheter ablation.
  
  
  RESULTS
  The PA-PDI interval was significantly correlated with the left atrial dimension (r=0.419, p=0.003), left atrial volume (r=0.827, p<0.001), left atrial voltage (r=-0.451, p<0.001) and left atrial activation time (r=0.547, p<0.001). During a follow-up of 23 ± 13 months, 36 patients (27% of the study population) had AF recurrence. The PA-PDI interval and left atrial volume were independent predictors of AF recurrence. At a cut-point of 160 ms, the Kaplan-Meier survival analysis showed that a long PA-PDI interval significantly predicted AF recurrence.
  
  
  CONCLUSIONS
  The PA-PDI interval can reflect the process of left atrial remodelling, such as a left atrial enlargement, prolonged activation time and decreased voltage. It was a convenient parameter for predicting recurrence after catheter ablation of paroxysmal AF.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.forename: Kang-Ling
authors.initials: KL
authors.lastname: Wang
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suenari
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Li
authors.forename: Kuo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Tsu-Juey
authors.initials: TJ
authors.lastname: Wu
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome