title: Correlation between total atrial conduction time estimated via tissue Doppler imaging (PA-TDI Interval), structural atrial remodeling and new-onset of atrial fibrillation after cardiac surgery.
abstract: BACKGROUND
  Recent studies identified total atrial conduction time (TACT) as an independent and powerful predictor of new-onset atrial fibrillation (AF). The purpose of this study was to assess the association between the degree of atrial fibrosis, TACT, and frequency of postoperative atrial fibrillation (POAF) among patients undergoing cardiac surgery.
  
  
  RESULTS
  Sixty patients in sinus rhythm (mean ± SD age 66 ± 10 years; 22% women) and without a history of AF undergoing cardiac surgery were prospectively enrolled. TACT was measured preoperatively in the left atrium by tissue-Doppler Imaging (PA-TDI interval). Holter-ECG/telemetry was used to screen for POAF throughout 10 days after cardiac surgery. Right atrial appendages (RAA) were obtained in 33 patients during surgery; atrial fibrosis was assessed by visual quantification (% area of positive van Gieson elastic staining). POAF occurred in 23 patients (38%). Fibrosis extent of RAA was higher in patients with POAF as compared to those without (27.5 ± 1.93 vs 15.8 ± 0.81% area; mean ± SEM; P < 0.001). PA-TDI interval was longer in patients with POAF versus patients who maintained in sinus rhythm (152.1 ± 3.0 vs 120.8 ± 1.8 milliseconds; P < 0.001) and correlated with the degree of atrial fibrosis (r = 0.73; P < 0.01). At the cut-off value of 133 milliseconds, TACT sensitivity and specificity related to POAF were 100% and 86%, respectively.
  
  
  CONCLUSIONS
  PA-TDI interval is useful to identify patients at risk for POAF undergoing cardiac surgery and correlates with the degree of atrial fibrosis.
authors: Divisions of Cardiology & Angiology, Ruhr-University Bochum, Germany. Patricktt83@yahoo.de
authors: Patrick
authors: P
authors: Müller
authors: Christine
authors: C
authors: Hars
authors: Fabian
authors: F
authors: Schiedat
authors: Leif I
authors: LI
authors: Bösche
authors: Michael
authors: M
authors: Gotzmann
authors: Justus
authors: J
authors: Strauch
authors: J W
authors: JW
authors: Dietrich
authors: Markus
authors: M
authors: Vogt
authors: Andrea
authors: A
authors: Tannapfel
authors: Thomas
authors: T
authors: Deneke
authors: Andreas
authors: A
authors: Mügge
authors: Aydan
authors: A
authors: Ewers
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000473:pathology; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D015150:Echocardiography, Doppler; D005260:Female; D005355:Fibrosis; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012680:Sensitivity and Specificity