CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 1, January/February 2014
AFRICA
19
Hormonal action may play a role in atrial conduction and
depolarisation. Increased oestradiol levels in pregrant women
may contribute to a longer PD. There are no data comparing PD
in men and women.
In our study, we demonstrated that atrial electromechanical
coupling intervals, P
max
and PD, which is a non-invasive technique
providing estimated risk ofAF in sinus rhythm, were significantly
more prolonged in pregnant subjects than in the controls. Our
study is the first of its kind to investigate the relationship of
atrial electromechanical coupling with pregnancy. We consider
that prolonged PD may be related to volume overload secondary
to pregnancy. We also believe that larger studies are needed to
clarify this issue.
This study had several limitations. It was a cross-sectional
study and the population size was relatively small. Intra-observer
variability of measurement of PA interval was not investigated.
Patients could not be followed up prospectively in terms of
detection of long-term cardiac arrhythmia. Other limitations
were the use of manual ECG measurements, absence of Holter
monitoring, and lack of electrophysiological evaluation. The
absence of strain rate parameters was another potential limitation
of our study.
Conclusion
This study demonstrated that atrial electromechanical coupling
intervals and PD, which are predictors of AF, were prolonged
in the pregnant subjects. These results suggest that longer atrial
electromechanical coupling intervals may cause an increased risk
of AF in pregnancy.
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