An echocardiographic tool for the interatrial conduction disorders – old dog, new tricks?

Background: Bachmann’s bundle plays a crucial role in the physiology of interatrial signal conduction. In the 1970s, Bayes de Luna introduced the definition of interatrial blocks (IABs), which negatively influence atrioventricular (AV) synchrony and left atrial (LA) activation. We aimed to assess the potential of LA strain technology in evaluating the mechanics of LA in patients with correct conduction and IABs. Additionally, we measured the parameters of regurgitation in pulmonary veins (PV), which depend on the type of interatrial conduction. Material and methods: The study group comprised 51 patients (26M, 25F) with symptomatic COVID-19 and sinus rhythm. Our study analyzed their medical history, electrocardiography (ECG) and echocardiography, including the LA strain parameters. Results: Global peak atrial longitudinal strain (PALS) depended on P wave duration, LA volume, left ventricular ejection fraction (LV EF) and inferior pulmonary veins (PV) regurgitation parameters. Global peak atrial contractile strain (PACS) statistically depends on the LV EF, LA volume and the P wave morphology. Conclusions: The presence of IABs negatively influences PACS and PALS. Examining LA strain is complementary to accurate ECG, which may be helpful in everyday clinical practice, particularly in diagnosing heart failure with preserved ejection fraction (HFpEF) and as a predictor of new episodes of atrial fibrillation (AF).