Assessment of atrial electromechanical delay in children with acute rheumatic fever

• Published in: Cardiology in the young Vol. 24; no. 1; pp. 27 - 32
• Main Authors: Çiftel, Murat, Turan, Özlem, Şimşek, Ayşe, Kardelen, Fırat, Akçurin, Gayaz, Ertuğ, Halil
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.02.2014
• Subjects: Adolescent; Arrhythmias, Cardiac - diagnostic imaging; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - physiopathology; Brugada Syndrome; Cardiac Conduction System Disease; Cardiomegaly - diagnostic imaging; Cardiomegaly - etiology; Cardiomegaly - physiopathology; Case-Control Studies; Child; Echocardiography, Doppler; Electrocardiography; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Conduction System - abnormalities; Heart Conduction System - diagnostic imaging; Heart Conduction System - physiology; Heart Conduction System - physiopathology; Humans; Male; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - etiology; Mitral Valve Insufficiency - physiopathology; Original Articles; Rheumatic Fever - complications; Rheumatic Fever - diagnostic imaging; Rheumatic Fever - physiopathology; atrial electromechanical delay; acute rheumatic fever; P-wave dispersion
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S104795111200193X

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. 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. 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). 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.