Echocardiographic findings in complete interatrial electrical dissociation in a patient after radiofrequency ablation
DOI:
https://doi.org/10.14739/2310-1237.2025.3.340030Keywords:
atrial fibrillation, radiofrequency ablation, interatrial electrical dissociation, echocardiography, speckle-trackingAbstract
Atrial fibrillation (AF) is one of the most common arrhythmias which increase the risk of thromboembolism and stroke. Catheter radiofrequency ablation (RFA) is an effective rhythm control method in patients with AF; however, in rare cases, interatrial electrical dissociation may develop.
Aim. To describe a clinical case of complete interatrial electrical dissociation in a patient after radiofrequency ablation for AF, diagnosed during echocardiographic examination.
Materials and methods. A single clinical case of a patient examined and treated at the “Uniclinic” (Zaporizhzhia, Ukraine) is presented. Clinical examination, ECG, and extended echocardiography with speckle-tracking analysis of atrial and ventricular function were performed.
Results. In a 63-year-old patient, one and a half years after RFA, echocardiographic signs of complete interatrial electrical dissociation were detected: Doppler assessment of the mitral inflow revealed the absence of the late diastolic A-wave, and left atrial strain analysis showed the absence of the contractile phase, whereas at the tricuspid valve Doppler imaging demonstrated preserved E and A peaks. Right atrial strain analysis showed preserved reservoir, conduit, and contractile phases. These findings were interpreted as evidence of complete interatrial electrical dissociation.
Conclusions. Complete interatrial electrical dissociation is a rare complication after RFA. Extended echocardiography with speckle-tracking analysis enables diagnosis of this condition. The presence of this complication requires continuation of anticoagulant therapy even in the absence of AF recurrence on ECG.
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