Electrocardiographic Predictors of Atrial Fibrillation

Authors

  • Mohamed Adam Eishaht Ali Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt Author
  • Magdy Mohamed Abd Al-Samea Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt Author
  • Mohammad Eltahlawi Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt Author
  • Radwa Abd Allah Elbelbesy Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt Author

DOI:

https://doi.org/10.48047/33tvbh59

Keywords:

Atrial fibrillation, Electrocardiography (ECG), P-wave dispersion, Interatrial block, PR interval, Atrial conduction abnormalities, Arrhythmia prediction, Cardiac electrophysiology.

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice and is associated with increased risk of stroke, heart failure, and all-cause mortality. Early identification of individuals at risk is crucial for timely intervention and prevention of complications. Electrocardiography (ECG), being a widely available, non-invasive, and cost-effective tool, provides valuable markers that may predict the development of AF. Several ECG parameters such as P-wave duration, dispersion, morphology, and axis deviation, as well as PR interval variability, atrial premature complexes, and abnormalities in interatrial conduction, have been linked to AF risk. Understanding these electrocardiographic predictors not only enhances risk stratification but also contributes to improved patient management, surveillance strategies, and the design of preventive therapies.

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References

Chugh, S.S., Havmoeller,R., Narayanan,K., Singh, D., et al.,(2014). Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation,25;129(8):837-847.

Qiu,D.,Peng ,L.,Ghista,D.N.,Wong,K.KL.,(2021). Left Atrial Remodeling Mechanisms Associated with Atrial Fibrillation. Cardiovasc Eng Technol. ,12(3),361-372.

Park, J.J., Park, J.H., Hwang, I.C., Park ,J.B., et al.,(2020). Left Atrial Strain as a Predictor of New-Onset Atrial Fibrillation in Patients With Heart Failure. JACC Cardiovasc Imaging,13(10),2071-2081.

Benjamin, E. J., Levy, D., Vaziri, S. M., D’Agostino, R. B., et al,(1994). Independent risk factors for atrial fibrillation in a population-based cohort: The Framingham Heart Study. JAMA, 271(11), 840–844.

Barletta, V., Mazzocchetti, L., Parollo, M., Spatafora, D., et al. (2021). Multimodality imaging for atrial fibrosis detection in the era of precision medicine. Journal of Cardiovascular Echography, 31, 189.

D’Ascenzo, F., Corleto, A., Biondi-Zoccai, G., Anselmino, M., et al. (2013). Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation? A meta-analysis. International Journal of Cardiology, 167(5), 1984–1989.

Tops L.F., Bax J.J., Zeppenfeld K., Jongbloed MR.M.,et al. (2006). Effect of Radiofrequency Catheter Ablation for12Atrial Fibrillation on Left Atrial Cavity Size. The AmericanJournal of Cardiology,97,1220–1222.

Kranert, M., Shchetynska-Marinova, T., et al. (2020). Recurrence of atrial fibrillation in dependence of left atrial volume index. In Vivo, 34(2), 889–896.

Lang, R. M., Badano, L. P., Mor-Avi, V., et al. (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28(1), 1–39.e14.

Badano, L.P., Pezzutto, N., Marinigh, R., Cinello, M., et al.,(2008). How many patients would be misclassified using M-mode and two-dimensional estimates of left atrial size instead of left atrial volume? a three-dimensional echocardiographic study. Journal of Cardiovascular Medicine,9,476–484.

Shin,S.,Park,M.,Oh,W.,Hong, S.,Pak ,H.,Song, W.,et al.(2008).Left AtrialVolume is a Predictor of Atrial Fibrillation Recurrence after Catheter Ablation. Journal of the American Society of Echocardiography, 21,697–702.

Tsang TSM, Barne, M.E., Bailey ,K.R., Leibson, C.L., et al. (2001). Montgomery SC, Takemoto Y, et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women.Mayo Clinic Proceedings.,76, 467–475.

Njoku, A., Kannabhiran, M., Arora ,R., Reddy, P., et al.,(2018). Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis. EP Europace.,20, 33–42.

Yoon ,Y.E.,Oh, I.,Kim ,S.,Park ,K.,Kim,S.H.,et al.(2015). Echocardiographic Predictors of Progression to Persistent or PermanentAtrial Fibrillation in Patients with Paroxysmal Atrial Fibrillation(E6P Study). Journal of the American Society of Echocardiography,28,709–717.

Matei, L.L., Popescu,R.M., Popescu, A.C., Bălănescu ȘM. (2022).Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle. Rev Cardiovasc Med.,23(6),205.

Badano, L.P.,Kolias,T.J.,Muraru, D.,Abraham, T.P.,Aurigemma, G.,et al.,(2018). Industry representatives; Re-viewers: This document was reviewed by members of the 2016–2018 EACVI Scientific Documents Committeel. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two dimensional speckle tracking echocardiography: A consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur. Heart J. Cardiovasc. Imaging ,19,591–600.

Kupczyńska K, Mandoli GE, Cameli M, Kasprzak JD. (2021). Left atrial strain — a current clinical perspective. Kardiologia Polska.,79,955–964.

Okamatsu,K.,Takeuchi,M., Otsuji,Y.,(2009). Effects of Aging on LeftAtrial Function Assessed by Two-Dimensional Speckle Tracking Echocardiography. Journal of the American Society ofEchocardiography,22,537–538.

Olsen FJ, Møgelvang R, Jensen GB, Jensen JS, Biering-Sørensen T., (2019). Relationship between Left Atrial Functional Measuresand Incident Atrial Fibrillation in the General Population.JACC: Cardiovascular Imaging,12, 981–989.

Thomas, L., Hoy, M., Byth,K., Schiller,N.B., (2008).The left atrial function index: a rhythm independent marker of atrial function. Eur.J. Echocardiogr., 9(3),356-62.

Sardana ,M., Lessard, D., Tsao, C..W, Parikh NI, et al.,(2018). Association of Left Atrial Function Index with Atrial Fibrillation and Cardiovascular Disease: The Framingham Offspring Study. J Am Heart Assoc.,7(7),e008435.

Sardana, M.,Ogunsua ,A.A.,Spring, M., Shaikh, A.,et al.,(2016). Association of Left Atrial Function Index W ith Late Atrial Fibrillation Recurrence after Catheter Ablation. J Cardiovasc Electrophysiol.,27(12),1411-1419.

Khan IA. (2003).Atrial stunning: Determinants and cellular mechanisms.American Heart Journal,145, 787–794.

Gentile F, Mantero A, Lippolis A, Ornaghi M, et al.,(1997). Pulmonary venous flow velocity patterns in 143 normal subjects aged 20 to 80 years old. An echo 2D colour Doppler cooperative study. Eur Heart J.,18(1),148-64.

Bollmann A.(2007). Pulmonary venous flow assessed by Doppler echocardiography in the management of atrial fibrillation .Echocardiography,24(4),430-435.

Buffle, E., Kramarz, J., Elazar, E., Aviram, G,et al.(2015).Added value of pulmonary venous flow Doppler assessment in patients with preserved ejection fraction and its contribution to the diastolic grading paradigm. Eur Heart J Cardiovasc Imaging ,16,1191 –1197.

Rosenberg ,M.A., Gottdiener, J.S, Heckbert S.R., et al.,(2012). Echocardiographic diastolic parameters and risk of atrial fibrillation: the Cardiovascular Health Study. Eur Heart J.,33(7),904-912.

Cho, Y. M., & Park, S. (2025). Age-Related Disparities in the Predictive Performance of the Shock Index for Massive Transfusion in Trauma Patients: A Retrospective Cohort Study. Journal of Clinical Medicine, 14(7), 2416.

Chen, P., Shi, Y., Ju, J,. Pan, D., Miao L, (2022).Left atrial appendage flow velocity predicts recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis. Front Cardiovasc Med, 2022 Sep 6;9:971848.

Gong, K., Yan, Q., Huang, R., Chen, J., Chen, X., et al. (2020). The impact of echocardiographic parameter ratio of E/E’ on the late recurrence of paroxysmal atrial fibrillation in patients undergoing radiofrequency catheter ablation: A retrospective clinical study. Medicine, 99(e19897).

Salah ,A., Yang, H,, Tang, L., Li ,X., Liu Q, Zhou S. (2015).Left atrial dyssynchrony time measured by tissue Doppler imaging to predict atrial fibrillation recurrences after pulmonary vein isolation. Anadolu Kardiyoloji Dergis.,15,115–122.

Den Uijl ,D.W., Gawrysiak ,M,Tops, L.F.,Trines ,S.A.,et al. (2011). Prognostic value of totalatrial conduction time estimated with tissue Doppler imaging topredict the recurrence of atrial fibrillation after radiofrequency catheter ablation. Europace,13,1533–1540.

Tjahjadi, C.,Hiemstra,Y.L.,van der Bijl,P., et al., (2020). Assessment of left atrial electromechanical delay to predict atrial fibrillation in hypertrophic cardiomyopathy.Eur Heart J Cardiovasc Imaging 22,589–596.

Müller ,P., Weijs ,B., Bemelmans, NMAA, Mügge, A., et al.,(2021). Echocardiography-derived total atrial conduction time (PA-TDI duration): risk stratification and guidance in atrial fibrillation management. Clin Res Cardiol.,110(11),1734-1742.

Bayar, N., Üreyen, ÇM,, ,Erkal, Z., Küçükseymen, S., et al.,(2016). Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation. Anatol J Cardiol.,16(8),572-578.

Yagmur, J., Yetkin, O., Cansel, M. et al. (2012).Assessment of atrial electromechanical delay and influential factors in patients with obstructive sleep apnea. Sleep Breath ,16,83–88.

Deniz, A., Sahiner, L., Aytemir, K., Kaya, B.,et al. (2012). Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time. Cardiol J.,19(5),487-493.

Avci, B.K., Gulmez, O., Donmez, G., Pehlivanoglu, S. (2016).Early Changes in Atrial Electromechanical Coupling in Patients with Hypertension: Assessment by Tissue Doppler Imaging. Chin Med J (Engl).,129(11),1311-1315.

Çiftel, M., Turan, Ö., Şimşek, A., Kardelen, F., et al.,(2014).Assessment of atrial electromechanical delay in children with acute rheumatic fever.Cardiology in the Young,24(1),27-32.

Evranos, B.,Aytemir,K.,Oto,A.,Okutucu, S.,et al.,(2013). Predictors of atrial fibrillation recurrence after atrial fibrillation ablation with cryoballoon. Cardiol J.20(3),294-303.

Voigt, J.-U., Mălăescu, G.-G.; Haugaa, K.; Badano, L. (2020). How to do LA strain. Eur. Heart J. Cardiovasc. Imaging ,21,715–717.

Molnár AA and MerkelyB .,(2022).The Added Value of Atrial Strain Assessment in Clinical Practice.Diagnostics (Basel).,12(4),982.

Saraiva,R.,Demirkol, S.,Buakhamsri, A.,Greenberg,N., et al.,( 2010). Left Atrial Strain Measured by Two-Dimensional Speckle Tracking Represents a New Tool to Evaluate Left Atrial Function. J. Am. Soc. Echocardiogr., 23,172–180.

Kuppahally, S.S., Akoum, N., Badger, T.J., Burgon, N.S., et al. et al.,(2010). Echocardiographic left atrial reverse remodeling after catheter ablation of atrial fibrillation is predicted by preablation delayed enhancement of left atrium by magneticresonance imaging. American Heart Journal,160, 877–884.

Lamy, J., Taoutel, R., Chamoun, R., Akar, J., et al. (2023). Atrial fibrosis by cardiac MRI is a correlate for atrial stiffness in patients with atrial fibrillation. Research Square [Preprint], 18, rs.3.rs-2818190.

Pathan F, Sivaraj E, Negishi K, Rafiudeen R, , et al.,(2018). Use of Atrial Strain to Predict Atrial Fibrillation After Cerebral Ischemia. JACC Cardiovasc Imaging,11(11),1557-1565.

Cameli, M., Mandoli, G.E., Loiacono, F., Sparla S.,et al.(2016). Left atrial strain: A useful index in atrial fibrillation. Int J Cardiol.,220,208-213.

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Published

2024-03-22

How to Cite

Electrocardiographic Predictors of Atrial Fibrillation (M. . A. Eishaht Ali, M. M. Abd Al-Samea, M. Eltahlawi, & R. A. Allah Elbelbesy , Trans.). (2024). Cuestiones De Fisioterapia, 53(02), 4089-4098. https://doi.org/10.48047/33tvbh59