Left atrial and left atrial appendage systolic function in patients with post-myocardial distal blocks

Introduction: The study aimed to evaluate function of the left atrium (LA) and of the left atrial appendage (LAA) after myocardial infarction (MI) complicated by intracardiac conduction disturbances.

Material and methods: The study comprised 59 patients with persistent post-myocardial distal blocks, who were allocated to one of the three following subgroups: study group I - 20 patients with left bundle branch block (LBBB); study group II - 20 patients with right bundle branch block (RBBB), and study group III -19 pts with left anterior hemiblock (LAHB). The control groups included patients with MI in their history and no BBBs (19 pts - group IV) and clinically healthy people (16 patients - group V). The parameters of LA and LAA systolic function were determined by means of transthoracic (TTE) and transoesophageal echocardiography (TOE).

Results: We showed that patients who experienced myocardial infarction not complicated with conduction disturbances expressed compensatory LA systolic function enhancement. In patients with post-myocardial RBBB and LAHB significant enhancement of LA systolic function was observed as well but it was expressed to a lesser degree. There was also a tendency towards deterioration of LA systolic function in patients with post-myocardial LBBB. LBBB did not affect LAA systolic function negatively.

Conclusions: Parameters of LAA systolic function showed its enhancement in all patients after myocardial infarction irrespective of whether it was complicated by conduction disturbances.