Assessment of relationship between atrial synchrony and paroxysmal atrial fibrillation by two-dimensional speckle tracking imaging in patients with sick sinus syndrome

• DOI: 10.3877/cma.j.issn.1672-6448.2018.03.005
• Publication Date: 2018-03-01
• Authors: Lingfei Zhu; Suya Ma
• Keywords: Sick sinus syndrome; P wave; Atrium (architecture); Paroxysmal atrial fibrillation; SSS*; Speckle tracking echocardiography

Objective To evaluate the relationship between atrial synchrony and paroxysmal fibrillation (PAF) in patients with sick sinus syndrome (SSS) by two-dimensional speckle tracking imaging.

Methods Forty-four SSS who underwent echocardiographic examination at Department of Ultrasound, No. 2 Hospital Yinzhou Ningbo City Zhejiang Province from January 2015 to August 2016 were enrolled, including 25 without PAF 19 PAF. Twenty-eight normal adults this department same time included as a control group. The structural functional parameters left ventricle all enrolled subjects evaluated examination. After images right atrium free wall, septum, wall obtained, interval initial point P wave on electrocardiograph second negative diastolic phase measured calculate electrical-mechanical (P-RA), septum (P-IAS), (P-LA) wall. Subsequently, calculated. Conventional parameters, P-RA, P-IAS, P-LA, compared among three groups one-way ANOVA, further comparisons any two performed SNK-q test. time, synchrony, analyzed Spearman correlation analysis. Receiver operating characteristic curve (ROC) analysis was then value predicting PAF.

Results The size significantly larger group than (q=4.18, 5.37, both P<0.05), although there no significant difference P-RA P-IAS (q=4.03, 4.10; q=4.16, 4.31, but intra-atrial inter-atrial showed gradually rising trend group, statistically (q=5.18, 11.23, 4.43; q=5.25, 11.74, 4.63; q=7.38, 14.67, 4.73; q=8.01, 16.37, 6.39, P<0.05). that positively correlated (r=0.61, 0.55, 0.75, 0.78, P<0.01), highest. ROC demonstrated optimal threshold P-LA for prediction 94 ms [sensitivity: 68.42%; specificity: 76.00%; area under (AUC): 0.764 (95% CI: 0.612-0.879)]; 57.89%; AUC: 0.714 0.558-0.840)]; 42 78.95%; 0.860 0.722-0.946)]; 68 84.21%; 84.00%; 0.859 0.721-0.945)]. These results suggest synchronization are superior SSS.

Conclusion Atrial electro-mechanical motion closely related SSS, most effective SSS.

Key words: Echocardiography; Sick syndrome; Paroxysmal fibrillation; Atrial