Evaluation of atrial fibrillation risk in patients with vasovagal syncope


ŞAHİN M., Comert A. D., KUTLU M.

HERZ, vol.47, no.1, pp.79-84, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 47 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.1007/s00059-021-05038-x
  • Journal Name: HERZ
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, BIOSIS, EMBASE, MEDLINE
  • Page Numbers: pp.79-84
  • Keywords: Fainting, Arrhythmia, Tilt table test, Autonomic nervous system, Atrial electromechanics, ELECTROMECHANICAL DELAY, AUTONOMIC TONE, MECHANICAL FUNCTIONS, ONSET
  • Karadeniz Technical University Affiliated: Yes

Abstract

Background This study aimed to determine whether autonomic dysfunction in patients with vasovagal syncope with a positive tilt test may cause an alteration in atrial electromechanical properties and pose a risk for subsequent atrial arrhythmias, especially atrial fibrillation. Methods The data of 27 patients with vasovagal syncope and a matched control group comprising 28 healthy individuals were compared. All patients underwent a tilt table test. Atrial electromechanical intervals (PA) were measured from the mitral lateral annulus, mitral septal annulus, and tricuspid annulus with tissue Doppler imaging. Left atrium volumes were measured with the disc method in apical four-chamber imaging. Results Although atrial electromechanical intervals such as lateral PA, septal PA, and tricuspid PA durations were significantly longer (p = 0.009, p = 0.002, p = 0.011, respectively), interatrial, right intra-atrial, and left intra-atrial durations were similar in the vasovagal syncope group and the control group (p = 0.298, p = 0.388, p = 0.069, respectively). Left atrial volumes (maximum, minimum, and presystolic) were significantly increased in the vasovagal syncope group when compared with the control group (p = 0.001, p = 0.001, p = 0.007, respectively). There was no difference between vasovagal syncope types in terms of atrial electromechanical intervals. Conclusion Interatrial and intra-atrial intervals were similar in the vasovagal syncope group and the control group. However, an increase in atrial volumes and a prolongation of certain atrial electromechanical intervals were observed in patients with vasovagal syncope. These findings suggest an alteration in atrial electromechanics caused by autonomic dysfunction that can lead to subsequent atrial arrhythmias, especially atrial fibrillation.