Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation

Owen A. Obel, L. Luddington, N. Maarouf, K. Aytemir, C. Ekwall, M. Malik, A. J. Camm

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To prospectively determine whether ventricular rate and regularity are significant determinants of the velocity and magnitude of left atrial appendage (LAA) flow. Design and patients: 12 patients with atrial fibrillation (AF), high degree atrioventricular block, and indwelling permanent pacemakers were studied. Setting: Cardiology department of a tertiary referral centre. Interventions: Pacing was triggered by an external programmable transcutaneous device. Patients were paced at 60, 120, and 150 beats/min in both regular and irregular rhythm. LAA flow velocity and magnitude were assessed with transoesophageal Doppler echocardiography. Main outcome measures: Peak and mean LAA inflow and outflow velocity, and time-velocity interval (TVI) of LAA flow. Results: Increasing ventricular rate was associated with significantly lower peak inflow (p < 0.01), peak outflow (p < 0.05), mean inflow (p < 0.01), and mean outflow (p < 0.05) velocities and with a lower TVI of LAA filling and emptying velocities (p < 0.01). This effect was noted at rates of 60 beats/min compared with both 120 and 150 beats/min. At a pacing rate of 120 beats/min there was a significantly higher total TVI when pacing at a regular than at an irregular rhythm (40.16 (14.6) cm v 30.74 (10.9) cm, p < 0.05). Conclusions: In this study, LAA filling velocities in patients in AF were significantly influenced by paced ventricular rate and to a much lesser extent ventricular rhythm. These results suggest that rapid ventricular rates may predispose to stasis in the LAA in AF.

Original languageEnglish (US)
Pages (from-to)764-768
Number of pages5
JournalHeart
Volume91
Issue number6
DOIs
StatePublished - Jun 2005

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Atrial Appendage
Atrial Fibrillation
Doppler Echocardiography
Atrioventricular Block
Transesophageal Echocardiography
Cardiology
Tertiary Care Centers
Outcome Assessment (Health Care)
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Obel, O. A., Luddington, L., Maarouf, N., Aytemir, K., Ekwall, C., Malik, M., & Camm, A. J. (2005). Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation. Heart, 91(6), 764-768. https://doi.org/10.1136/hrt.2003.030940

Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation. / Obel, Owen A.; Luddington, L.; Maarouf, N.; Aytemir, K.; Ekwall, C.; Malik, M.; Camm, A. J.

In: Heart, Vol. 91, No. 6, 06.2005, p. 764-768.

Research output: Contribution to journalArticle

Obel, OA, Luddington, L, Maarouf, N, Aytemir, K, Ekwall, C, Malik, M & Camm, AJ 2005, 'Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation', Heart, vol. 91, no. 6, pp. 764-768. https://doi.org/10.1136/hrt.2003.030940
Obel, Owen A. ; Luddington, L. ; Maarouf, N. ; Aytemir, K. ; Ekwall, C. ; Malik, M. ; Camm, A. J. / Effects of ventricular rate and regularity on the velocity and magnitude of left atrial appendage flow in atrial fibrillation. In: Heart. 2005 ; Vol. 91, No. 6. pp. 764-768.
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AU - Obel, Owen A.

AU - Luddington, L.

AU - Maarouf, N.

AU - Aytemir, K.

AU - Ekwall, C.

AU - Malik, M.

AU - Camm, A. J.

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N2 - Objective: To prospectively determine whether ventricular rate and regularity are significant determinants of the velocity and magnitude of left atrial appendage (LAA) flow. Design and patients: 12 patients with atrial fibrillation (AF), high degree atrioventricular block, and indwelling permanent pacemakers were studied. Setting: Cardiology department of a tertiary referral centre. Interventions: Pacing was triggered by an external programmable transcutaneous device. Patients were paced at 60, 120, and 150 beats/min in both regular and irregular rhythm. LAA flow velocity and magnitude were assessed with transoesophageal Doppler echocardiography. Main outcome measures: Peak and mean LAA inflow and outflow velocity, and time-velocity interval (TVI) of LAA flow. Results: Increasing ventricular rate was associated with significantly lower peak inflow (p < 0.01), peak outflow (p < 0.05), mean inflow (p < 0.01), and mean outflow (p < 0.05) velocities and with a lower TVI of LAA filling and emptying velocities (p < 0.01). This effect was noted at rates of 60 beats/min compared with both 120 and 150 beats/min. At a pacing rate of 120 beats/min there was a significantly higher total TVI when pacing at a regular than at an irregular rhythm (40.16 (14.6) cm v 30.74 (10.9) cm, p < 0.05). Conclusions: In this study, LAA filling velocities in patients in AF were significantly influenced by paced ventricular rate and to a much lesser extent ventricular rhythm. These results suggest that rapid ventricular rates may predispose to stasis in the LAA in AF.

AB - Objective: To prospectively determine whether ventricular rate and regularity are significant determinants of the velocity and magnitude of left atrial appendage (LAA) flow. Design and patients: 12 patients with atrial fibrillation (AF), high degree atrioventricular block, and indwelling permanent pacemakers were studied. Setting: Cardiology department of a tertiary referral centre. Interventions: Pacing was triggered by an external programmable transcutaneous device. Patients were paced at 60, 120, and 150 beats/min in both regular and irregular rhythm. LAA flow velocity and magnitude were assessed with transoesophageal Doppler echocardiography. Main outcome measures: Peak and mean LAA inflow and outflow velocity, and time-velocity interval (TVI) of LAA flow. Results: Increasing ventricular rate was associated with significantly lower peak inflow (p < 0.01), peak outflow (p < 0.05), mean inflow (p < 0.01), and mean outflow (p < 0.05) velocities and with a lower TVI of LAA filling and emptying velocities (p < 0.01). This effect was noted at rates of 60 beats/min compared with both 120 and 150 beats/min. At a pacing rate of 120 beats/min there was a significantly higher total TVI when pacing at a regular than at an irregular rhythm (40.16 (14.6) cm v 30.74 (10.9) cm, p < 0.05). Conclusions: In this study, LAA filling velocities in patients in AF were significantly influenced by paced ventricular rate and to a much lesser extent ventricular rhythm. These results suggest that rapid ventricular rates may predispose to stasis in the LAA in AF.

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