Echocardiography-derived total atrial conduction time (PA-TDI duration): risk stratification and guidance in atrial fibrillation management.
Patrick MüllerBob WeijsNadine M A A BemelmansAndreas MüggeLars EckardtHarry J G M CrijnsJeroen J BaxDominik LinzDennis W den UijlPublished in: Clinical research in cardiology : official journal of the German Cardiac Society (2021)
Atrial fibrillation (AF) is a major cause of cardiovascular morbidity and mortality. To early detect and to avoid AF-related complications, several cardiac imaging modalities and approaches aim to quantify the severity of the underlying atrial cardiomyopathy (i.e., the extent of atrial remodeling). However, most established cardiac imaging modalities just incorporate single components of atrial remodeling and do not reflect the complete multifactorial process, which may contribute to their limited predictive value. Echocardiography-derived PA-TDI duration is a sophisticated echocardiographic parameter to assess total atrial conduction time and directly reflects both electrical and structural changes to the atria. Therefore, PA-TDI duration provides a more comprehensive quantification of the extent of atrial remodeling than other imaging modalities. In this article we review the role of PA-TDI duration as a marker of atrial remodeling and summarize the available data on PA-TDI duration to identify patients at risk for AF, as well as to guide AF management. Moreover, we discuss how to assess PA-TDI duration and provide recommendations on the implementation of PA-TDI duration into routine clinical care.
Keyphrases
- atrial fibrillation
- left atrial
- catheter ablation
- oral anticoagulants
- left ventricular
- heart failure
- direct oral anticoagulants
- left atrial appendage
- high resolution
- percutaneous coronary intervention
- healthcare
- pulmonary hypertension
- end stage renal disease
- ejection fraction
- quality improvement
- chronic kidney disease
- primary care
- newly diagnosed
- patient reported outcomes
- big data
- venous thromboembolism
- clinical practice
- electronic health record
- artificial intelligence
- deep learning
- pain management
- mass spectrometry