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Background: Pulsed-field ablation (PFA) is an alternative to thermal ablation (TA) in patients with atrial fibrillation (AF) receiving catheter-based therapy for pulmonary vein isolation (PVI). However, its efficacy and safety have yet to be fully elucidated. Objective: The purpose of this study was to compare the acute and long-term efficacies and safety of PFA and TA. Methods: We performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials comparing PFA and TA in patients with AF undergoing their first PVI ablation. The TA group was divided into cryoballoon (CB) and radiofrequency subgroups. AF patients were divided into paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PersAF) subgroups for further analysis. Results: Eighteen studies involving 4998 patients (35.2% PFA) were included. Overall, PFA was associated with a shorter procedure time (mean difference [MD] -21.68; 95% confidence interval [CI] -32.81 to -10.54) but longer fluoroscopy time (MD 4.53; 95% CI 2.18-6.88) than TA. Regarding safety, lower (peri-)esophageal injury rates (odds ratio [OR] 0.17; 95% CI 0.06-0.46) and higher tamponade rates (OR 2.98; 95% CI 1.27-7.00) were observed after PFA. In efficacy assessment, PFA was associated with a better first-pass isolation rate (OR 6.82; 95% CI 1.37-34.01) and a lower treatment failure rate (OR 0.83; 95% CI 0.70-0.98). Subgroup analysis showed no differences in PersAF and PAF. CB was related to higher (peri)esophageal injury, and lower PVI acute success and procedural time. Conclusion: Compared to TA, PFA showed better results with regard to acute and long-term efficacy but significant differences in safety, with lower (peri)esophageal injury rates but higher tamponade rates in procedural data.

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Abstract Aim: To analyse the potential usefulness and clinical relevance of the assessment by echocardiography with left atrial strain, based on the myocardial atrial deformation curves with speckle-tracking velocity vector imaging (VVI), in the analysis of short-form recurrent atrial extra systoles in ambulatory patients not suffering from organic cardiopathy. Methods: We designed a descriptive, prospective, and observational study including 270 patients between the ages of 18 and 75 assessed during an outpatient cardiology consultation attended due to palpitations over a period of two years. Using ambulatory electrocardiographic monitoring, we selected cases with short forms of repetitive atrial extrasystole, isolated or recurrentatrial fibrillation and a control group formed by those patients without repetitive ectopia. All patients underwent a thorough echocardiographic study during their first cardiological visit. Results: The analysis of the dynamic curves segmental deformation generated after an atrial extrasystole can reveal different points of origin of the extrasystole and detect specific anatomical alterations in the interatrial conduction at the level of the Bachmann's fascicle showing different models of electro anatomical activation possibly involved in the appearance of repetitive forms. Higher values of dyssynchrony between the septal and lateral wall and elongation in the time of interatrial electromechanical conduction could also be related to the existence of repetitive ectopic beats. Conclusions: Our ambulatory study employing the left atrial longitudinal strain, particularly in its segmental analysis, provides new insights into its the usefulness and potential clinical relevance.

Resumen Objetivo: Analizar la utilidad y relevancia clínica de la evaluación mediante ecocardiografía basada en las curvas de deformación auricular miocárdica con imágenes vectoriales de velocidad (VVI) de speckle-tracking, en el análisis de las extrasístoles auriculares recurrentes de corta duración en pacientes ambulatorios sin cardiopatía orgánica. Métodos: Se diseñó un estudio descriptivo, prospectivo y observacional que incluyó a 270 pacientes de entre 18 y 75 años evaluados durante una consulta externa de cardiología a la que acudieron por palpitaciones durante un periodo de dos años. Mediante el uso de monitorización electrocardiográfica ambulatoria, se seleccionaron casos con formas cortas de extrasistolia auricular repetitiva, fibrilación auricular aislada o repetitiva y un grupo control formado por aquellos pacientes sin ectopia repetitiva. Todos los pacientes se sometieron a un estudio ecocardiográfico exhaustivo durante su primera visita cardiológica. Resultados: El análisis de las curvas dinámicas de deformación segmentaria generadas tras un extrasístole auricular diferentes modelos de activación electroanatómica posiblemente implicados en la aparición de formas repetitivas. Valores mayores de disincronía entre la pared septal y lateral y el alargamiento en el tiempo de conducción electromecánica intraauricular pudieran también relacionarse con la existencia de latidos ectópicos repetitivos. Conclusiones: Nuestro estudio ambulatorio empleando la deformación longitudinal auricular izquierda, particularmente en su análisis segmentario, proporciona nuevas perspectivas sobre su utilidad y potencial relevancia clínica.

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Aim: To analyse the potential usefulness and clinical relevance of the assessment by echocardiography with left atrial strain, based on the myocardial atrial deformation curves with speckle-tracking velocity vector imaging (VVI), in the analysis of short-form recurrent atrial extra systoles in ambulatory patients not suffering from organic cardiopathy. Methods: We designed a descriptive, prospective, and observational study including 270 patients between the ages of 18 and 75 assessed during an outpatient cardiology consultation attended due to palpitations over a period of two years. Using ambulatory electrocardiographic monitoring, we selected cases with short forms of repetitive atrial extrasystole, isolated or recurrentatrial fibrillation and a control group formed by those patients without repetitive ectopia. All patients underwent a thorough echocardiographic study during their first cardiological visit. Results: The analysis of the dynamic curves segmental deformation generated after an atrial extrasystole can reveal different points of origin of the extrasystole and detect specific anatomical alterations in the interatrial conduction at the level of the Bachmann's fascicle showing different models of electro anatomical activation possibly involved in the appearance of repetitive forms. Higher values of dyssynchrony between the septal and lateral wall and elongation in the time of interatrial electromechanical conduction could also be related to the existence of repetitive ectopic beats. Conclusions: Our ambulatory study employing the left atrial longitudinal strain, particularly in its segmental analysis, provides new insights into its the usefulness and potential clinical relevance.

Objetivo: Analizar la utilidad y relevancia clínica de la evaluación mediante ecocardiografía basada en las curvas de deformación auricular miocárdica con imágenes vectoriales de velocidad (VVI) de speckle-tracking, en el análisis de las extrasístoles auriculares recurrentes de corta duración en pacientes ambulatorios sin cardiopatía orgánica. Métodos: Se diseñó un estudio descriptivo, prospectivo y observacional que incluyó a 270 pacientes de entre 18 y 75 años evaluados durante una consulta externa de cardiología a la que acudieron por palpitaciones durante un periodo de dos años. Mediante el uso de monitorización electrocardiográfica ambulatoria, se seleccionaron casos con formas cortas de extrasistolia auricular repetitiva, fibrilación auricular aislada o repetitiva y un grupo control formado por aquellos pacientes sin ectopia repetitiva. Todos los pacientes se sometieron a un estudio ecocardiográfico exhaustivo durante su primera visita cardiológica. Resultados: El análisis de las curvas dinámicas de deformación segmentaria generadas tras un extrasístole auricular diferentes modelos de activación electroanatómica posiblemente implicados en la aparición de formas repetitivas. Valores mayores de disincronía entre la pared septal y lateral y el alargamiento en el tiempo de conducción electromecánica intraauricular pudieran también relacionarse con la existencia de latidos ectópicos repetitivos. Conclusiones: Nuestro estudio ambulatorio empleando la deformación longitudinal auricular izquierda, particularmente en su análisis segmentario, proporciona nuevas perspectivas sobre su utilidad y potencial relevancia clínica.

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Abstract BACKGROUND: Prevention of recurrence of stroke depends on recognition of the underlying mechanism of ischemia. OBJECTIVE: To screen patients who were hospitalized with diagnosis of acute ischemic stroke in terms of atrial fibrillation (AF) with repeated Holter electrocardiography recordings. DESIGN AND SETTING: Prospective study conducted at Konya Education and Research Hospital, Turkey. METHODS: Patients with a diagnosis of acute ischemic stroke, without atrial fibrillation on electrocardiography (ECG), were evaluated. Their age, gender, histories of previous ischemic attack, occurrences of paroxysmal atrial fibrillation (PAF) and other risks were assessed during the first week after acute ischemic stroke and one month thereafter. ECG recordings were obtained from 130 patients through 24-hour ambulatory Holter. Patients without PAF attack during the first Holter were re-evaluated. RESULTS: PAF was detected through the first Holter in 33 (25.4%) out of 130 acute ischemic stroke patients. A second Holter was planned for 97 patients: 53 (54.6%) of them could not attend due to COVID-19 pandemic; while 44 (45.3%) patients had the second Holter and, among these, 4 (9.1%) had PAF. The only parameter associated with PAF was older age. Four (10.8%) of the 37 patients with PAF had also symptomatic carotid stenosis. CONCLUSIONS: Detecting the presence of PAF by screening patients with no AF in the ECG through Holter ECG examinations is valuable in terms of changing the course of the treatment. It should be kept in mind that the possibility of accompanying PAF cannot be ruled out in the presence of other factors that pose a risk of stroke.

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Atrial fibrillation (AF) is the most clinically diagnosed arrhythmia, as its prevalence increases with age, and its initial stage is paroxysmal atrial fibrillation (PAF). This pathology usually triggers hemodynamic disorders that can generate cerebrovascular accidents (CVA), causing morbidity and even death. The aim of this study is to predict the occurrence of PAF episodes in order to take precautions to prevent PAF episodes. The PhysioNet AFPDB prediction database was used to extract 77 heart rate variability (HRV) features using time domain, geometrical analysis, Poincaré plot, nonlinear analysis, detrended fluctuation analysis, autoregressive modeling, fast Fourier transform (FFT), Lomb-Scargle periodogram, wavelet packet transform (WPT) and bispectrum measurements. The number of features was reduced using the near-zero value, correlation, and recursive feature elimination (RFE) methods for time windows of 1, 2, 5, 10, and 30 min. Feature selection was performed using backwards selection, genetic algorithm, analysis of variance (ANOVA), and non-dominated sorting genetic algorithm (NSGA-III) methods, and then random forest, conditional random forest, k-nearest neighbor (KNN), and support vector machine (SVM) classification algorithms were applied and evaluated using 10-fold cross-validation. The proposed method achieved a precision of 93.24% with a 5-minute window and 89.21% with a 2-minute window, improving performance in predicting PAF when compared with similar studies in the literature.

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A 38-year-old male patient consulted for nocturnal palpitations described as fast chest pounding that woke him up from sleep. A physical examination yielded no remarkable findings. A 24-hour Holter ECG monitoring demonstrated nocturnal episodes of paroxysmal atrial fibrillation (PAF) with the coexistence of wide QRS complex tachycardia. To the best of our knowledge, this is the first reported case of nocturnal episodes of wide QRS complex tachycardia during vagally mediated PAF resulting from Gouaux-Ashman's phenomenon. It is paramount for general physicians to recognize this phenomenon because it should be differentiated from ventricular tachycardia, since prognosis and treatment of both entities are entirely different. General and emergency physicians should be aware in order to improve adequate diagnostic and therapeutic management of the arrhythmic episodes.

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Resumen Objetivo: Evaluar la seguridad y eficacia del cierre percutáneo de la orejuela izquierda en pacientes con fibrilación auricular no valvular con alto riesgo de sangrado o con contraindicación para anticoagulación oral. Métodos: Estudio prospectivo no aleatorizado en una cohorte de pacientes con fibrilación auricular con contraindicación o dificultades con anticoagulación oral y puntaje de CHA2DS2-VASc ≥ 2 y de HASBLED ≥ 2, elegibles para doble antiagregación con aspirina y clopidogrel. Resultados: Se incluyeron 53 pacientes, con edad promedio de 72,24 ± 9,22 años, de los cuales 54,72% eran hombres; 20,75% tenían fibrilación auricular paroxística, 15,1% persistente y 64,15% permanente. Además, 18,9% tenían insuficiencia cardíaca, 22,64% enfermedad coronaria, 92,45% hipertensión arterial, 41,51% eran mayores de 75 años, 18,9% eran diabéticos y 37,7% tenían enfermedad cerebrovascular previa. El promedio del puntaje de CHADS2 y CHA2DS2-VASc fue de 2,73 ± 1,34 y 4,24 ± 1,54, respectivamente. El procedimiento fue exitoso en un 98% (52/53). Sólo en un caso no fue posible implantar el dispositivo por causas anatómicas. No hubo eventos adversos serios relacionados con la implantación; durante el procedimiento se registró un episodio de derrame pericárdico leve que no requirió drenaje. En los 45 días de seguimiento, 2 pacientes (3,77%) desarrollaron enfermedad cerebrovascular y se registró un deceso por causa no cardíaca (1,89%). Conclusiones: El cierre percutáneo de la orejuela izquierda con dispositivo WATCHMAN® es un procedimiento seguro y eficaz en pacientes de alto riesgo con fibrilación auricular no valvular y contraindicación o dificultades para la anticoagulación oral.

Abstract Motivation: To assess the safety and efficacy of percutaneous left atrial appendage closure in patients with non-valvular atrial fibrillation with a high risk of bleeding or a contraindication to oral anticoagulation drugs. Methods: Prospective non-randomised study of a cohort of patients with atrial fibrillation who had a contraindication to or difficulties with oral anticoagulation, CHA2DS2-VASc ≥ 2 and HASBLED ≥ 2 scores, and who were eligible for dual antiaggregation therapy with aspirin and clopidogrel. Results: 53 patients with an average age of 72.24 ± 9.22 years were included, out of whom 54.72% were men, 20.75% had paroxysmal, 15.1% persistent and 64.15% permanent atrial fibrillation, respectively. Besides, 18.9% suffered from heart failure, 22.64% from coronary disease, 92.45% from arterial hypertension, 41.51% were over 75 years old, 18.9% were diabetic and 37.7% had a history of cerebrovascular disease. Average CHADS= y CHA=DS2-VASc scores were of 2.73 ± 1.34 and 4.24 ± 1.54 respectively. Procedure was successful in 98% of the cases (52/53). It was not possible to implant the device in only one case due to anatomical reasons. There were no severe adverse events related to the insertion; during the procedure an episode of mild pericardial effusion that did not require drainage was registered. DUring the 45-day follow up period, 2 patients (3.77%) developed a cerebrovascular disease, and there was one noncardiac death (1.89%). Conclusions: The percutaneous left atrial appendage closure with device is a safe and efficient procedure in high-risk patients with non-valvular atrial fibrillation and contraindications to or difficulties for oral anticoagulation therapy.

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Amiodarone is still the most potent antiarrhythmic drug in the prevention of life threatening ventricular arrhythmias and demonstrates a very low incidence of torsade de pointes. An unusual case of an 81-year-old woman who developed serious abnormalities of the conduction system of the heart and torsade des pointes during intravenous infusion of amiodarone for the treatment of paroxysmal atrial fibrillation is described. To the best of our knowledge, this is the first case showing an association of intravenous amiodarone-induced third degree atrioventricular block and extreme QT interval prolongation generating torsade des pointes in a patient with paroxysmal atrial fibrillation who required an implantable cardioverter-defibrillator. Currently, amiodarone is still one of the few remaining treatment options for the medical therapeutic management of serious ventricular arrhythmias and to reduce the incidence of atrial fibrillation without increasing mortality or sudden cardiac death rates in heart failure patients like our elderly present patient. Nevertheless, we have to keep in mind that intravenous amiodarone may generate serious abnormalities of the conduction system of the heart and lethal ventricular arrhythmias in certain patients.

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La fibrilación auricular (FA) es la arritmia más común. Algunos episodios de FA son mantenidos por rotores. La FA paroxística (FAp) se refiere a episodios recurrentes que se autolimitan. Si la FAp no se trata puede convertirse en crónica. Se ha demostrado que la inhibición de las corrientes I KACh e I K1 contribuye a la terminación de la FA. El fármaco antimalárico cloroquina, al inhibir estas corrientes podría ser un fármaco antiarrítmico eficaz en humanos. El objetivo del trabajo es simular los efectos de la cloroquina y estudiar su eficacia en la terminación de un rotor en condiciones de FAp. Para esto, se desarrolló un modelo 2D de tejido auricular en condiciones de FAp. Se implementó un modelo del efecto de la cloroquina sobre las corrientes I K1 e I KACh para estudiar su eficacia en la terminación de un rotor simulado. La cloroquina alargó el potencial de acción a medida que se incrementó su concentración. A concentraciones de 0.3 µM y superiores, finalizó la actividad del rotor. Este es el primer trabajo que ha desarrollado modelos matemáticos del fármaco cloroquina para estudiar su efecto en la terminación de un rotor. Los resultados sugieren que la cloroquina podría ser un potente agente antiarrítmico en el tratamiento de la FAp.

Atrial fibrillation (AF) is the most common arrhythmia. Some AF episodes are maintained by rotors. Paroxysmal AF (pAF) refers to self-limiting recurrent episodes. If the pAF is not treated it could become chronic. It has been demonstrated that inhibition of the I K1 and I KACh currents contributes to AF termination. Antimalarial drug chloroquine by inhibiting these currents could be an effective antiarrhythmic drug in humans. The aim of this work is to simulate the effects of chloroquine and study their effectiveness in the rotor termination in pAF conditions. For this, we developed a 2D model of atrial tissue under pAF conditions. We implemented a model of the effect of chloroquine on I K1 and I KACh currents to study its effectiveness in the termination of a simulated rotor. Chloroquine lengthened the action potential as the concentration increased. At concentrations of 0.3 µM and higher, the activity of the rotor finished. This is the first work that developed a chloroquine mathematical models to study its effect on the rotor termination. The results suggest that chloroquine could be a potent antiarrhythmic drug for the pAF treatment.

A fibrilhação auricular (FA) é a arritmia mais comum. Alguns episódios de FA são mantidos por rotores. A FA paroxística (FAp) refere-se a episódios recorrentes que são autolimitantes. Se a FAP não tem nenhum tratamento, pode se tornar crônica. Tem sido demonstrado que a inibição das correntes I KACh e I K1 contribui para o término da AF. O medeicamento antimalárico cloroquina, para inibir essas correntes poderia ser um medicamento anti-arrítmico eficaz em seres humanos. O objetivo deste trabalho é simular os efeitos da cloroquina e estudar a sua eficácia na terminação de um rotor capaz em condições FAp. Para isso, um modelo 2D foi desenvolvido de tecido auricular em condições de FAp. foi implementado um modelo do efeito da Cloroquina sobre as corrente I K1 e I KACh para estudar a sua eficácia na terminação de um rotor simulado. A Cloroquina alongou o potencial de ação na medida em que foi aumentada a sua concentração. Em concentrações de 0,3 µM e superiores, terminou a atividade do rotor. Este é o primeiro trabalho que desenvolveu modelos matemáticos do medicamento cloroquina para estudar seu efeito sobre a terminação de um rotor. Os resultados sugerem que a cloroquina poderia ser um potente agente anti-arrítmico para o tratamento de FAp.

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Se presenta el caso clínico de un paciente de 41 años de edad con antecedente de cambio valvular aórtico con una prótesis mecánica. Acude por presencia de disnea y palpitaciones a un centro hospitalario, donde le diagnostican fibrilación auricular paroxística y aparente fuga paravalvular severa, es enviado asintomático a un hospital de referencia. Negó síntomas anteriores al evento, se realiza ecocardiograma y estudios complementarios, encontrando aneurisma de raíz de aorta que simula la aurícula derecha.

We present the case report of a male aged 41 with a history of aortic valve replacement with a mechanical prosthesis. He presents dyspnea and palpitations in his local hospital, where they are diagnosed paroxysmal atrial fibrillation and severe paravalvular leak, He comes asymptomatic to our service, and denies symptoms prior to the event. It is performed echocardiography and complementary studies finding an aneurysm of the aortic root, simulating the right atrium.

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Background: Highly trained athletes are at increased risk of atrial fibrillation (AF) and flutter. Atrial dilatation and dysfunction might be the underlying substrate for the increased risk. The aim of the present study was to relate atrial size and deformation in a selected group of highly trained athletes and patients with paroxysmal atrial fibrillation (PAF). Methods: 20 professional male hand-ball players, 18 patients with PAF and 20 healthy age-matched, non-sportive males were compared. All subjects underwent a transthoracic echocardiogram with evaluation of left atrial (LA) dimensions. Left atrial strain (LASa) and strain rate (LASRa) derived from speckle tracking were used to evaluate LA deformation post atrial contraction. Results: LA volumes were significantly larger in athletes and PAF patients compared to controls (36 + 1.7 ml/m2; 36 ± 2.3 ml/m2 and 24 + 1 ml/m2, respectively, p < 0.01;). LASa and LASRa during active atrial contraction were decreased in PAF patients compared to athletes and controls (-10.6 ± 0.2 %; -12.2 ± 0.4 % and -14.5 ± 0.5 %, p < 0.01 for LASa and -1.2 ± 0.08 sec-1; -1.5 ± 0.12 sec-1; -1.7 ± 0.13 sec-1, p= 0.04 for LASRa respectively). Athletes with LA volume > 40 ml/m2 (n=7) showed reduced LASa compared to athletes with LA volume < 40 mL/m2 (-10.3 ± 0.4% versus -13.0 ± 0.5%, p < 0.01). PAF patients had LASa values similar to those of subjects with normal LA volume. Conclusion: Athletes with increased LA volume exhibit lower strain parameters compared to subjects with PAF. It is postulated that measurement of LA strain may be used to predict development of AF in highly trained athletes.

Introducción: Atletas de alto rendimiento tienen un riesgo aumentado de desarrollar fibrilacion auricular (FA) y flutter. La dilatación y disfunción auricular podrían ser el sustrato subyacente para este incremento en el riesgo. El objetivo fue analizar y relacionar el tamaño y deformación auricular en un grupo seleccionado de atletas y en pacientes con FA paroxística. Métodos: Se incluyeron 20 jugadores de balón-mano profesionales y 20 controles sedentarios, pareados por edad y sexo, junto a 18 pacientes con FA paroxística. En todos los sujetos se realizó un estudio ecocardiográfico bidimensional con evaluación de las dimensiones y de la deformación (post contracción auricular) por strain (Sa) y strain rate (SRa) de la aurícula izquierda (AI). Resultados: El volumen AI fue significativamente mayor en atletas y pacientes con FA respecto de los controles (36 + 1,7 ml/m2; 36 ± 2,3 ml/m2 y 24 + 1 ml/m2, p < 0,01; respectivamente). El SaAI y SRaAI durante la contracción auricular estaban disminuidos en los pacientes con FA paroxística respecto de atletas y controles (-10,6 ± 0,2 %; -12,2 ± 0,4 % y -14,5 ± 0,5 %, p < 0,01 para SaAI y -1,2 ± 0,08 sec-1; -1,5 ± 0,12 sec-1; -1,7 ± 0,13 sec-1, p= 0,04 para SRaAI, respectivamente). Los atletas con un volumen AI > 40 ml/m2 (n=7) mostraron valores reducidos de SaAI comparados con atletas con un volumen AI < 40 mL/m2 (-10,3 ± 0,4% versus -13,0 ± 0,5%, p < 0,01) y éstos fueron similares a los pacientes con FA (-10,3 ± 0,4% versus -10,6 ± 0,2%, p= 0,6). Conclusiones: Una proporción de atletas con dilatación AI presentan evidencia de disfunción contráctil de la AI, caracterizado por valores de strain disminuidos que son similares a los de pacientes con FA paroxística. Esto podría corresponder a un sustrato para el desarrollo posterior de arritmias auriculares en estos atletas.

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BACKGROUND: Atrial fibrillation is the most common significant cardiac arrhythmia in clinical practice, but its risk factors remain to be clarified. We have hypothesized that left ventricular posterior wall thickness is an independent risk factor for paroxysmal atrial fibrillation (PAF). METHODS: A total of 166 consecutive patients with paroxysmal atrial fibrillation were included in this study. Another 166 healthy check-up people, strictly age and sex-matched, were enrolled as controls in the same period. Univariable analysis and multivariable conditional logistic stepwise regression analysis were conducted. Receiver operating characteristic (ROC) curve analysis was performed on those significant indices obtained from the multivariable logistic regression analysis. RESULTS: The multivariable stepwise analysis identified left ventricular posterior wall thickness, left atrial diameter, tricuspid insufficiency and residence (countryside) as independent predictors for paroxysmal atrial fibrillation. Receiver operating characteristic curve analysis demonstrated the cut-off values of those risk factors aforementioned. CONCLUSIONS: In this strictly age and sex-matched population-based sample, left ventricular posterior wall thickness, left atrial diameter, tricuspid insufficiency and residence were predictive risks for paroxysmal atrial fibrillation. This study offers novel information therapeutically beyond that provided by traditional clinical atrial fibrillation risk factors.

ANTECEDENTES: La fibrilación atrial o auricular, es la arritmia cardíaca significativa más común en la práctica clínica, pero sigue siendo aún necesario poner en claro sus factores de riesgo. El presente trabajo asume la hipótesis de que el grosor de la pared posterior ventricular izquierda constituye un factor de riesgo independiente para la fibrilación atrial paroxística (FAP). MÉTODOS: El estudio abarca un total de 166 pacientes consecutivos con fibrilación atrial paroxística. Otras 166 personas saludables según el reconocimiento médico, pareadas estrictamente por edad y sexo, fueron registradas como controles en el mismo periodo. Se llevó a cabo un análisis de regresión logística condicional multivariante paso a paso y un análisis univariante. El análisis de la curva característica de la operación del receptor (ROC) se realizó sobre los índices significativos obtenidos a partir del análisis de regresión logística multivariante. RESULTADOS: El análisis multivariante paso a paso identificó el grosor de la pared posterior ventricular izquierda, el diámetro atrial izquierdo, la insuficiencia tricúspide y la residencia (el campo) como predictores independientes de la fibrilación atrial paroxística. El análisis de la curva característica de la operación del receptor demostró los valores límites de los factores de riesgo mencionados arriba. CONCLUSIONES: En esta muestra basada estrictamente en una población pareada por edad y género, el grosor de la pared posterior ventricular izquierda, el diámetro atrial izquierdo, la insuficiencia tricús-pide y la residencia, fueron riesgos predictivos de la fibrilación atrial paroxística. Este estudio ofrece información novedosa, terapéuticamente más allá de la proporcionada por los factores de riesgo clínicos tradicionales de la fibrilación atrial.

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