Assessment of short forms of recurrent atrial extra systoles by echocardiography with left atrial strain in ambulatory patients without organic cardiopathy




José M. Soler, Cardiology Department, Hospital Nostra Senyora de Meritxell, Barcelona, Spain
Gemma García-Parés, Psychiatrist Mental Health Department, Hospital Nostra Senyora de Meritxell. Andorra la Vella, Andorra, Barcelona, Spain
Oliver Valero, Statistical Department, Universitat Autònoma de Barcelona, Barcelona, Spain
Antonio Berruezo, Cardiology Department, Heart Institute, Teknon Medical Center, Barcelona, Spain
Victor J. Yuste, Cell Death, Senescence and Survival Group, Departament de Bioquímica i Biologia Molecular/Institut de Neurociències, Facultat de Medicina, Universitat Autònoma de Barcelona. Barcelona, Spain
María Antonia Baltrons, Cell Death, Senescence and Survival Group, Departament de Bioquímica i Biologia Molecular/Institut de Neurociències, Facultat de Medicina, Universitat Autònoma de Barcelona. Barcelona, Spain


Aim: To analyse the potential usefulness and clinical relevance of the assessment by echocardiography with left atrial strain, based on the myocardial atrial deformation curves with speckle-tracking velocity vector imaging (VVI), in the analysis of short-form recurrent atrial extra systoles in ambulatory patients not suffering from organic cardiopathy. Methods: We designed a descriptive, prospective, and observational study including 270 patients between the ages of 18 and 75 assessed during an outpatient cardiology consultation attended due to palpitations over a period of two years. Using ambulatory electrocardiographic monitoring, we selected cases with short forms of repetitive atrial extrasystole, isolated or recurrentatrial fibrillation and a control group formed by those patients without repetitive ectopia. All patients underwent a thorough echocardiographic study during their first cardiological visit. Results: The analysis of the dynamic curves segmental deformation generated after an atrial extrasystole can reveal different points of origin of the extrasystole and detect specific anatomical alterations in the interatrial conduction at the level of the Bachmann?s fascicle showing different models of electro anatomical activation possibly involved in the appearance of repetitive forms. Higher values of dyssynchrony between the septal and lateral wall and elongation in the time of interatrial electromechanical conduction could also be related to the existence of repetitive ectopic beats. Conclusions: Our ambulatory study employing the left atrial longitudinal strain, particularly in its segmental analysis, provides new insights into its the usefulness and potential clinical relevance.



Palabras clave: Premature atrial contractions. Short atrial runs. Paroxysmal atrial fibrillation. Left atrial strain. Left atrial dyssynchrony.