Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-15T04:50:52.507Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of atrial electromechanical delay in children with acute rheumatic fever

Published online by Cambridge University Press:  12 November 2012

Murat Çiftel ,
Özlem Turan ,
Ayşe Şimşek ,
Fırat Kardelen ,
Gayaz Akçurin  and
Halil Ertuğ
Murat Çiftel*
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Özlem Turan
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Ayşe Şimşek
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Fırat Kardelen
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Gayaz Akçurin
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Halil Ertuğ
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
*
Correspondence to: M. Çiftel, Specialist Doctor, Department of Pediatric Cardiology, Faculty of Medicine, Akdeniz University, Dumlupınar Boulevard, Antalya 07058, Turkey. Tel: +90 0 242 2274343; Fax: +90 0 242 2274482; E-mail: nefrotik@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose

There may be an increase in the risk of atrial arrhythmia due to left atrial enlargement and the influence on conduction system in acute rheumatic fever. The aim of this study is to investigate atrial electromechanical delay and P-wave dispersion in patients with acute rheumatic fever.

Patients

A total of 48 patients diagnosed with acute rheumatic fever and 40 volunteers of similar age, sex, and body mass index were included in the study. The study groups were compared for M-mode echocardiographic parameters, interatrial electromechanical delay, intra-atrial electromechanical delay, and P-wave dispersion.

Results

Maximum P-wave duration, P-wave dispersion, and interatrial electromechanical delay were significantly higher in patients with acute rheumatic fever compared with the control group (p < 0.001). However, there was no difference in terms of intra-atrial electromechanical delay (p > 0.05). For patients with acute rheumatic fever, a positive correlation was identified between the left atrium diameter and the P-wave dispersion and interatrial electromechanical delay (r = 0.524 and p < 0.001, and r = 0.351 and p = 0.014, respectively). Furthermore, an important correlation was also identified between the P-wave dispersion and the interatrial electromechanical delay (r = 0.494 and p < 0.001).

Conclusion

This study shows the prolongation of P-wave dispersion and interatrial electromechanical delay in acute rheumatic fever. Left atrial enlargement can be one of the underlying reasons for the increase in P-wave dispersion and interatrial electromechanical delay.

Keywords

P-wave dispersionacute rheumatic feveratrial electromechanical delay
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 27 - 32
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Carapetis, JR, McDonald, M, Wilson, NJ. Acute rheumatic fever. Lancet 2005; 366: 155–168.Google Scholar
2. Narula, J, Chandrasekhar, Y, Rahimtoola, S. Diagnosis of active rheumatic carditis. The echoes of change. Circulation 1999; 100: 1576–1581.Google Scholar
3. Ravisha, MS, Tullu, MS, Kamat, JR. Rheumatic fever and rheumatic heart disease: clinical profile of 550 cases in India. Arch Med Res 2003; 34: 382–387.Google Scholar
4. Kocaoglu, C, Sert, A, Aypar, E, et al. P-wave dispersion in children with acute rheumatic fever. Pediatr Cardiol 2012; 33: 90–94.Google Scholar
5. Daubert, JC, Pavin, D, Jauvert, G, Mabo, P. Intra- and interatrial conduction delay: implications for cardiac pacing. Pacing Clin Electrophysiol 2004; 27: 507–525.Google Scholar
6. Cui, QQ, Zhang, W, Wang, H, et al. Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 2008; 31: 74–78.Google Scholar
7. Omi, W, Nagai, H, Takamura, M, et al. Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. J Am Soc Echocardiogr 2005; 18: 39–44.Google Scholar
8. Dilaveris, PE, Gialafos, EJ, Sideris, SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998; 135: 733–738.Google Scholar
9. Dilaveris, PE, Gialafos, JE. P-wave dispersion: a novel predictor of paroxysmal atrial fibrillation. Ann Noninvasive Electrocardiol 2001; 6: 159–165.Google Scholar
10. Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association, JAMA 1992; 268: 2069–2073.Google Scholar
11. Kimball, TR, Michelfelder, EC. Echocardiography. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF (eds.). Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, 7th edn. Lippincott Williams & Wilkins, Philadelphia, 2008, pp 95–163.Google Scholar
12. Patel, VV, Ren, JF, Marchlinski, FE. A comparison of left atrial size by two-dimensional transthoracic echocardiography and magnetic endocardial catheter mapping. Pacing Clin Electrophysiol 2002; 25: 95–97.Google Scholar
13. Otto, CM. Valvular Regurgitation: Diagnosis Quantitation and Clinical Approach. In: Otto CM. Text book of Clinical Echocardiography, 2nd edn. Saunders Company, 2000, pp 265–300.Google Scholar
14. Rheumatic fever and rheumatic heart disease. World Health Organization Technical Report Series 2004; 923: 1–122.Google Scholar
15. Ozer, N, Yavuz, B, Can, I, et al. Doppler tissue evaluation of intra-atrial and interatrial electromechanical delay and comparison with P-wave dispersion in patients with mitral stenosis. J Am Soc Echocardiogr 2005; 18: 945–948.Google Scholar
16. Dogdu, O, Yarlioglues, M, Kaya, MG, et al. Assessment of atrial conduction time in patients with systemic lupus erythematosus. J Investig Med 2011; 59: 281–286.Google Scholar
17. Köken, R, Demir, T, Sen, TA, Kundak, AA, Oztekin, O, Alpay, F. The relationship between P-wave dispersion and diastolic functions in diabetic children. Cardiol Young 2010; 20: 133–137.Google Scholar
18. Ozyilmaz, I, Eroğlu, AG, Güzeltaş, A, et al. Duration and dispersion of the P wave after the Senning operation. Cardiol Young 2009; 19: 615–619.Google Scholar
19. den Uijl, DW, Gawrysiak, M, Tops, LF, et al. Prognostic value of total atrial conduction time estimated with tissue Doppler imaging to predict the recurrence of atrial fibrillation after radiofrequency catheter ablation. Europace 2011; 13: 1533–1540.Google Scholar
20. Daubert, JC, Pavin, D, Jauvert, G, Mabo, P. Intra- and interatrial conduction delay: implications for cardiac pacing. Pacing Clin Electrophysiol 2004; 27: 507–525.Google Scholar
21. Baspinar, O, Sucu, M, Koruk, S, et al. P-wave dispersion between transcatheter and surgical closure of secundum-type atrial septal defect in childhood. Cardiol Young 2011; 21: 15–18.Google Scholar
22. Ozaydin, M, Turker, Y, Varol, E, et al. Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis. Int J Cardiovasc Imaging 2010; 26: 547–552.Google Scholar
23. Kabukçu, M, Arslantas, E, Ates, I, Demircioglu, F, Ersel, F. Clinical, echocardiographic, and hemodynamic characteristics of rheumatic mitral valve stenosis and atrial fibrillation. Angiology 2005; 56: 159–163.Google Scholar
24. Yagmur, J, Cansel, M, Acikgoz, N, et al. Assessment of atrial electromechanical delay by tissue Doppler echocardiography in obese subjects. Obesity 2011; 19: 779–783.Google Scholar
25. Parkash, R, Green, MS, Kerr, CR, et al. The association of left atrial size and occurrence of atrial fibrillation: a prospective cohort study from the Canadian Registry of Atrial Fibrillation. Am Heart J 2004; 148: 649–654.Google Scholar