title: Conduction characteristics in atrial fibrillation. Predictive value of tissue Doppler echocardiography.
abstract: BACKGROUND
  Atrial fibrillation (AF) is one of the most common arrhythmias observed in clinical practice. The frequency of AF is increased in patients with impaired interatrial conduction. We aimed to investigate whether tissue Doppler echocardiography could be used for the evaluation of atrial conduction characteristics instead of an electrophysiological study, and to examine the predictive accuracy of tissue Doppler echocardiography for the inducibility of sustained AF.
  
  
  METHODS
  We enrolled 86 consecutive patients who underwent an electrophysiological study. We performed electrocardiographic P wave dispersion, M-mode, two-dimensional, Doppler, and tissue Doppler echocardiography as well as an electrophysiological study (EPS) to evaluate the intra- and interatrial conduction times. We tried to induce AF, and the patients were categorized according to the inducibility of sustained (> 120 s) AF.
  
  
  RESULTS
  We found a good correlation between intra-left atrial conduction time detected by tissue Doppler echocardiography (ILCT-echo) and by EPS (ILCT-eps; r = 0.744, p < 0.001), and a weak correlation between interatrial conduction times (IACT-echo and IACT-eps, r = 0.396, p < 0.001). In patients with inducible sustained AF, P wave dispersion (46 ± 19 ms vs. 27 ± 18, p < 0.001), ILCT-echo (29 ± 10 ms vs. 17 ± 7 ms, p < 0.001), and IACT-eps (47 ± 11 ms vs. 36 ± 13 ms, p < 0.001) were found to be higher than those of the noninducible/nonsustained AF group. These three parameters were independent predictors of the inducibility of sustained AF.
  
  
  CONCLUSIONS
  We demonstrated that ILCT-echo could be used instead of ILCT-eps for the evaluation of left atrial conduction characteristics. We also showed that ILCT-eps could be a valuable parameter for predicting the development of long-lasting AF.
authors.affiliation: Department of Cardiology, Balcali Hospital, Çukurova University Hospital , Saricam/Adana, Turkey, alideniz78@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Deniz
authors.forename: D Y
authors.initials: DY
authors.lastname: Sahin
authors.forename: M
authors.initials: M
authors.lastname: Kanadasi
authors.forename: M
authors.initials: M
authors.lastname: Demir
authors.forename: I G
authors.initials: IG
authors.lastname: Berk
authors.forename: O
authors.initials: O
authors.lastname: Akkus
authors.forename: M
authors.initials: M
authors.lastname: Koc
authors.forename: M
authors.initials: M
authors.lastname: Cayli
authors.forename: A
authors.initials: A
authors.lastname: Usal
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015150:Echocardiography, Doppler / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity