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Open AccessArticle

Evaluation of Atrial Electromechanical Delay to Predict Atrial Fibrillation in Hemodialysis Patients

Department of Cardiology, Sutcu Imam University, 46040 Kahramanmaras, Turkey
Department of Cardiology, Cumhuriyet University, 58140 Sivas, Turkey
Department of Nephrology, Sutcu Imam University, 46040 Kahramanmaras, Turkey
Author to whom correspondence should be addressed.
Medicina 2018, 54(4), 58;
Received: 17 July 2018 / Revised: 20 August 2018 / Accepted: 23 August 2018 / Published: 25 August 2018
Background and objective: Prevalence of atrial fibrillation is higher in hemodialysis patients as compared to the general population. Atrial electromechanical delay is known as a significant predictor of atrial fibrillation. In this study, we aimed to reveal the relationship between atrial electromechanical delay and attacks of atrial fibrillation. Materials and methods: The study included 77 hemodialysis patients over 18 years of age giving written consent to participate in the study. The patients were divided into two groups based on the results of 24-h Holter Electrocardiogram (Holter ECG) as the ones having attacks of atrial fibrillation and the others without any attack of atrial fibrillation. Standard echocardiographic measurements were taken from all patients. Additionally, atrial conduction times were measured by tissue Doppler technique and atrial electromechanical delays were calculated. Results: Intra- and interatrial electromechanical delay were found as significantly lengthened in the group of patients with attacks of atrial fibrillation (p = 0.03 and p < 0.001 respectively). The optimal cut-off time for interatrial electromechanical delay to predict atrial fibrillation was >21 ms with a specificity of 79.3% and a sensitivity of 73.7% (area under the curve 0.820; 95% confidence interval (CI), 0.716–0.898). In the multivariate logistic regression model, interatrial electromechanical delay (odds ratio = 1.230; 95% CI, 1.104–1.370; p < 0.001) and hypertension (odds ratio = 4.525; 95% CI, 1.042–19.651; p = 0.044) were also associated with atrial fibrillation after adjustment for variables found to be statistically significant in univariate analysis and correlated with interatrial electromechanical delay. Conclusions: Interatrial electromechanical delay is independently related with the attacks of atrial fibrillation detected on Holter ECG records in hemodialysis patients. View Full-Text
Keywords: atrial electromechanical delay; atrial fibrillation; hemodialysis atrial electromechanical delay; atrial fibrillation; hemodialysis
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Gunes, H.; Sokmen, A.; Kaya, H.; Gungor, O.; Kerkutluoglu, M.; Guzel, F.B.; Sokmen, G. Evaluation of Atrial Electromechanical Delay to Predict Atrial Fibrillation in Hemodialysis Patients. Medicina 2018, 54, 58.

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