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Left Atrial Dimension (leave + atrial_dimension)

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Medical Sciences100%

Selected Abstracts

ORIGINAL INVESTIGATIONS: Comparison of Left Atrial Dimensions by Transesophageal and Transthoracic Echocardiography

ECHOCARDIOGRAPHY, Issue 10 2005
Harshinder Singh M.D.
Transesophageal echocardiography (TEE) is an established cardiovascular diagnostic technique. Left atrial (LA) size, as measured by transthoracic echocardiography (TTE), is associated with cardiovascular disease and is a risk factor for atrial fibrillation, stroke, death, and the success of cardioversion. Assessment of LA size has not been as well validated on TEE as on TTE. We determined LA size measurements in four standard views in 122 patients undergoing TEE and TTE at the same setting. In this study, we found that measurement of LA dimensions by TEE suffers from significant limitations in all views except the basal long-axis view (mid-esophageal level) with transducer plane at 120,150 degrees. This view had the best correlation with transthoracic LA measurements: r = 0.79 for TEE long axis (CI 0.71,0.85), P <.0001. (ECHOCARDIOGRAPHY, Volume 22, November 2005) [source]

Heritability of left atrial size in the Tecumseh population

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 7 2002
P. Palatini
Abstract Background ,Little is known about the determinants of atrial size, and no study has analyzed whether genetic factors are involved in the pathogenesis of LA enlargement. Materials and methods We studied the heritability of echocardiographic left atrial size in 290 parents from the Tecumseh Blood Pressure Study and 251 children from the Tecumseh Offspring Study. All data from the parents and children were obtained at the same field office in Tecumseh, USA. Left atrial dimension was determined echocardiographically in accordance with American Society of Echocardiography guidelines with the use of leading-edge-to-leading-edge measurements of the maximal distance between the posterior aortic root wall and the posterior left atrial wall at end systole. Results For correlation between the left atrial dimensions of the parents and their offspring, several models were generated to adjust the atrial dimensions in both groups for an increasing number of clinical variables. After removing the effect of age, gender, height, weight, skinfold thickness, and systolic blood pressure, parent,child correlation for left atrial size was 0·19 (P = 0·007). Further adjustment for left ventricular mass and for measuring left ventricular diastolic function increased the correlation to 0·25 (P = 0·001). Conclusions ,The present data indicate that heredity can explain a small but definite proportion of the variance in left atrial dimension. [source]

Determinants of Persistent Atrial Fibrillation in Patients with DDD Pacemaker Implantation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2003
AHMET DURAN DEMIR
DEMIR, A.D., et al.: Determinants of Persistent Atrial Fibrillation in Patients with DDD Pacemaker Implantation.Occurrence of AF in a pacemaker implanted patient is a significant cause of morbidity and mortality. The aim of this study was to prospectively investigate the clinical, echocardiographic, and electrocardiographic determinants of persistent AF in patients with DDD pacemakers. A 101 consecutive patients were followed for an average of19.8 ± 11.8months. Persistent AF was documented in 21 (20.8%) patients and 80 (79.2%) patients were in sinus or physiologically paced rhythm. In patients with persistent AF, previous AF attacks were observed more frequently(P < 0.03)and left atrial dimension was higher(3.5 ± 0.6vs3.0 ± 0.5 cm, P < 0.001). Average P maximum and P wave dispersion (PWD) values calculated in a 12-lead surface electrocardiogram were also found to be significantly higher in patients with persistent AF(P < 0.001). Cox regression analysis demonstrated that the presence of previous AF attacks(RR 8.95, P < 0.001), increased left atrial dimension(RR 2.1, P < 0.02), P maximum duration120 ms (RR 6.1, P < 0.001), and PWD 40 ms(RR 12.2, P < 0.001)were associated with an increased risk of persistent AF. Cut-off points were 120 ms for P maximum and 40 ms for PWD. Sensitivity, specificity, and positive and negative predictive values were calculated as 76.2, 82.5, 53.3, and 92.9 for P maximum and as 85.7, 87.5, 64.3, and 95.9 for PWD, respectively. In patients with DDD pacemakers, previous AF attacks, increased left atrial dimension, P maximum value of 120 ms, and a PWD value of 40 ms were associated with a significantly increased risk of persistent AF. These patients must further be managed with other treatment modalities to prevent the development of persistent AF. (PACE 2003; 26:719,724) [source]

Heritability of left atrial size in the Tecumseh population

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 7 2002
P. Palatini
Abstract Background ,Little is known about the determinants of atrial size, and no study has analyzed whether genetic factors are involved in the pathogenesis of LA enlargement. Materials and methods We studied the heritability of echocardiographic left atrial size in 290 parents from the Tecumseh Blood Pressure Study and 251 children from the Tecumseh Offspring Study. All data from the parents and children were obtained at the same field office in Tecumseh, USA. Left atrial dimension was determined echocardiographically in accordance with American Society of Echocardiography guidelines with the use of leading-edge-to-leading-edge measurements of the maximal distance between the posterior aortic root wall and the posterior left atrial wall at end systole. Results For correlation between the left atrial dimensions of the parents and their offspring, several models were generated to adjust the atrial dimensions in both groups for an increasing number of clinical variables. After removing the effect of age, gender, height, weight, skinfold thickness, and systolic blood pressure, parent,child correlation for left atrial size was 0·19 (P = 0·007). Further adjustment for left ventricular mass and for measuring left ventricular diastolic function increased the correlation to 0·25 (P = 0·001). Conclusions ,The present data indicate that heredity can explain a small but definite proportion of the variance in left atrial dimension. [source]

Catheter Ablation for Paroxysmal Atrial Fibrillation: A Randomized Comparison between Multielectrode Catheter and Point-by-Point Ablation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2010
ALAN BULAVA M.D., Ph.D.
Introduction:,Catheter ablation for paroxysmal atrial fibrillation is widely used for patients with drug-refractory paroxysms of arrhythmia. Recently, novel technologies have been introduced to the market that aim to simplify and shorten the procedure. Aim:,To compare the clinical outcome of pulmonary vein (PV) isolation using a multipolar circular ablation catheter (PVAC group), with point-by-point PV isolation using an irrigated-tip ablation catheter and the CARTO mapping system (CARTO group; CARTO, Biosense Webster, Diamond Bar, CA, USA). Methods:,Patients with documented PAF were randomized to undergo PV isolation using PVAC or CARTO. Atrial fibrillation (AF) recurrences were documented by serial 7-day Holter monitoring. Results:,One hundred and two patients (mean age 58 ± 11 years, 68 men) were included in the study. The patients had comparable baseline clinical characteristics, including left atrial dimensions and left ventricular ejection fraction, in both study arms (PVAC: n = 51 and CARTO: n = 51). Total procedural and fluoroscopic times were significantly shorter in the PVAC group (107 ± 31 minutes vs 208 ± 46 minutes, P < 0.0001 and 16 ± 5 minutes vs 28 ± 8 minutes, P < 0.0001, respectively). The AF recurrence was documented in 23% and 29% of patients in the PVAC and CARTO groups, respectively (P = 0.8), during the mean follow-up of 200 ± 13 days. No serious complications were noted in both study groups. Conclusions:,Clinical success rates of PV isolation are similar when using multipolar circular PV ablation catheter and point-by-point ablation with a three-dimensional (3D) navigation system in patients with PAF, and results in shorter procedural and fluoroscopic times with a comparable safety profile. (PACE 2010; 33:1039,1046) [source]