title: Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  This study aimed to evaluate the association between the history of stroke/transient ischemic attack (TIA) and inter- and intra-atrial electromechanical delay (EMD) in patients with paroxysmal atrial fibrillation (PAF).
  
  
  METHODS
  Patients diagnosed with PAF were included in this retrospective study. Patients who had a history of stroke or TIA were defined as the symptomatic group, whereas those who did not have such a history were defined as the asymptomatic group. On the basis of the transthoracic echocardiographic records, atrial electromechanical coupling (time interval from the onset of the P wave on the surface electrocardiogram to the beginning of the A' wave interval with tissue Doppler echocardiography) and intra- and interatrial EMD were measured.
  
  
  RESULTS
  In this study, 160 patients were included, 52 of whom were symptomatic. While the intra-left atrial EMD was 68.2±6.1 ms in the symptomatic group, it was found to be 50.8±6.5 ms in the asymptomatic group (p<0.001). Interatrial EMD was 91.3±5.0 ms in the symptomatic group, whereas it was 71.5±7.0 ms in the asymptomatic group (p<0.001). In multiple logistic regression analysis, intra-left atrial [odds ratio (OR): 1.417, 95% confidence interval (CI): 1.193-1.684, p<0.001] and interatrial EMDs (OR: 1.398, 95% CI: 1.177-1.661, p<0.001) were found to be independently associated with the presence of stroke/TIA.
  
  
  CONCLUSIONS
  Prolonged inter- and intra-left atrial EMDs in patients with PAF is associated with stroke/TIA. Evaluating this parameter in addition to the CHA2DS2-VASc score in patients with PAF may be helpful in identifying patients who are at a high risk of stroke/TIA.
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey. dr.nermin@mynet.com.
authors.forename: Nermin
authors.initials: N
authors.lastname: Bayar
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Çağın Mustafa
authors.initials: ÇM
authors.lastname: Üreyen
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Erkal
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Küçükseymen
authors.affiliation: Department of Cardiology, Yu¨ksek İhtisas Education and Research Hospital, Ankara-Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Çay
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Göksel
authors.initials: G
authors.lastname: Çağırcı
authors.affiliation: Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Arslan