Evaluation of left and right atrial synchrony in patients with sick sinus syndrome before and after pacemaker implantation by tissue Doppler ultrasonography / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the intra- and interatrial synchronization before and after pacemaker implantation in patients with sick sinus syndrome ( SSS) by tissue Doppler imaging ( TDI) . Methods Thirty-eight patients with SSS ( SSS group ) underwent pacemaker implantation . Echocardiography was performed before and after operation . Twenty-five volunteers were chosen as control group . Routine measurement of left and right atrial diameter by echocardiography . In apical four chamber view ,the sample volume of TDI was located at right atrial lateral wall at tricuspid annulus ,interatrial septum and left atrial lateral wall at mitral annulus . The interval time between the early diastolic wave ( E wave) and the late diastolic wave (A wave) (E-AR ,E-AI ,E-AL ) ,and the duration of A wave (AR ,AI ,AL ) were measured . At the same time ,the electromechanical coupling time was measured ,namely the initiation of the P wave of the synchronous electrocardiogram to the starting point of A wave ( P-A0R ,P-A0I ,P-A0L ) , and the starting point of the P wave to the peak point of the A wave ( P-AR ,P-AI ,P-AL ) . And the right atrial electromechanical delay time ,P-A0I and P-A0R value ( T0IR ) ,P-AI value and P-AR value ( TIR ) were recorded .Other parameters include left atrial electromechanical delay timeP-A0L and P-A0I value ( T0LI ) , and P-AL and P-AI value ( TLI ) ;interatrial electromechanical delay timeP-A0L and P-A0R value ( T0LR ) ,P-AL and P-AR ( TLR ) were recorded . Results Compared with the control group ,left atrium and right atrium in SSS group enlarged before operation , E-AR ,E-AI ,E-AL ,P-A0R ,P-A0I ,P-AR ,P-AL prolonged ,while T0LR and T0LI were shortened ( all P < 0 .05 ) . Postoperative changes in SSS group patients included shortened E-AR ,E-AI and E-AL ,and prolonged T0LI and T0LR ( all P <0 .05) . Compared with the control group ,the size of left atriums and right atriums in SSS group still increased postoperation ,and the P-A0I 、P-AR and P-AL remained longer (all P <0 .05) . The same as the control group ,the postoperative AR ,AI and AL in SSS group were decreased successively ( all P < 0 .05 ) . Conclusions In SSS patients , electromechanical asynchrony exists in different part of atrium and between left atrium and right atrium . Pacemaker therapy can improve atrial electromechanical synchronicity .