Role of Inter Atrial and Left Atrial Desynchrony Assessed by Tissue Doppler Imaging in Predicting Atrial Fibrillation in Patient with ST-Elevation Myocardial Infarction

Background: Atrial fibrillation (AF) frequently occurs among individuals having STEMI and is linked to a worse clinical prognosis. AF is characterized by irregular and often rapid contractions of the atrial cardiomyocytes, leading to a range of symptoms, including an unpredictable heart rhythm, palpitations, dizziness, shortness of breath, and fatigue. Objectives: This work aimed to study the role of interatrial desynchrony and LA desynchrony (determined utilizing tissue Doppler) in predicting AF among STEMI cases. Methods: Our prospective cohort study involved 100 patients. Patients were categorized into two groups based on AF development: Group 1 (n=11), who developed AF, and Group 2 (n=89), who did not develop AF. Electrocardiogram (ECG), transthoracic echocardiography, and tissue Doppler imaging (TDI) were evaluated for all cases. Results: A robust positive association exists between LA desynchrony and interatrial desynchrony among cases with anterior myocardial infarction (MI). At a cut-off point (24.5), the sensitivity and specificity of Interatrial desynchrony by echo in predicting the AF incidence among cases having anterior MI is 63.6 % and 78.7 %, respectively. At the cut-off point of 22.5, the sensitivity and specificity of LA desynchrony by echo in predicting the AF incidence among cases having anterior MI is 63.6 % and 79.8 %, respectively. The mean maximin p wave and p wave dispersion exhibited significantly greater values within the AF group. Hypertension and dyslipidemia were significantly higher in the AF group. Conclusion: Interatrial and LA desynchrony calculated by tissue Doppler have significant accuracy as predictors of AF for STEMI patients.