الفهرس 
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Abstract
Atrial electromechanical delays (AEMDs) are defined as the time intervals between the atrial electrical depolarization and the initiation of atrial mechanical contraction. It has been shown that prolonged AEMDs can be used as markers to discriminate patients with paroxysmal atrial fibrillation (PAF) from controls without PAF or to predict the occurrence of PAF in case-control or observational studies.The clinical evidence supports the notion that prolonged AEMDs reflect left atrial electrical remodeling, which is essential for the maintenance of atrial fibrillation.This study is a descriptive cross sectional study that was conducted in order to assess effect of fasting and post prandial condition on left atrium electromechanical delay in healthy non diabetic subjects.It had been done on 55 subjects in the Cardiology Department of Specialized Medical Hospital, Faculty of Medicine; Mansoura University; during the period from July 2017 to July 2018.It was done after approval of the local ethics committee and the patient’s informed consent was obtained. Healthy middle aged persons of both sex were included. We excluded patients with past medical history of HTN, DM, renal disease, chronic liver disease and patients with structural heart disease or history of arrhythmia.The study included 55 subjects, 33 males, and 22 females with their age ranged from 21 to 47 years with mean age of 33.27±7.49 years.Subjects were subjected to medical history, clinical examination, Electrocardiography and ECG gated Echocardiography using conventional echocardiography and TDI with assessment of left atrial EMD. Left atrium EMD is prolonged in smokers than in non-smokers.Left atrium EMD is prolonged in males more than in females.Left atrium EMD is prolonged in older age than in younger.We conclude that EMD may be the underlying pathophysiologic mechanism for postprandial arrhythmia in some patients. The cause of this delay may be related to the transient postprandial glucose execursions. If that is the cause, it will give us a big question about the protective upper level of blood glucose on cardiovascular events especially arrhythmia.. Other mechanisms may be responsible for that delay as mechanical stimulation of the LA by the distended esophagus, vasovagal reflex ,adrenergic reflex and some dietary components as theobramine.