Theodora Benedek², I.A. Sârbu-Pop², Claudia Matei¹, Monica Chitu¹, I. Kovacs², Diana Horga¹, Melinda

Kurtinecz¹, Zsuzsanna Suciu², Sz. Madaras², I. Benedek¹

¹ Emergency County Hospital Tg Mureș, Cardiology Clinic

² Medicine and  Pharmacy University Tg Mureș, Discipline of Internal Medicine 6

Purpose: The  aim  of our  study was to  use  the  Computerized 3D  Echocardiography (C3DE)  in complex and  objective assesment of left atrial  (LA) remodelling extension in two different treatment strategies (rate  control versus rhythm control) in atrial  fibrillation (AF). Methods: 31  patients with AF, gr.1  – 16  pts  converted to sinus rhythm 3 months before examination, and  gr.2  – 15  pts  with no con- version to  sinus rhythm, who received medical therapy for  rate  control. In all patients we  performed a computerized analysis of  LA shape, geometry and  volumes, using an adapted Qlab software in which reference points were  identified at pulmonary vein insertions and  mitral annulus, followed by manual adjustment of LA tracing borders. A 3D spatial model of LA and  a volumetric contraction-filling curve of LA were  obtained in this  way  for  each patient. In parallel, we  performed the  standard C3DE for  assesment of left ventricular function.

Results: LA  maximum volumes were  54,5 ml  in gr.1  and  66.5 ml  in   gr  2 (p=0.02). LA  .   maximum diameters were  43 mm in gr.1  compared with 52 mm in gr.2  (p=0.02). Contraction curves of the left ventricle showed a superior ejection fraction in the rhythm control group – 54%, compared with the  rate  control group with an EF of 44% (p<0.001).

Conclusions: C3DE could represent a useful method for assesment of LA remodelling process in Atrial  fibrillation. The data obtained in our  study with this  method support the  superiority of conversion to sinus rhythm as a therapeutic option in patients with AF.

Tags: Atrial remodelling, Computerized 3D Echocardiography, fibrillation