engleski

Left atrial strain predicts atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation and preserved ejection fraction treated with catheter ablation

Background: Atrial fibrillation (AF) frequently recurs after radiofrequency catheter ablation (CA). This study investigated novel echocardiographic strain parameters as predictors of outcome in AF treated with CA. Methods: 110 patients (mean age 59, mean CHA2DS2-VASc = 1.37) with paroxysmal AF and preserved ejection fraction (EF) underwent CA and echocardiography ≤ 30 days prior to CA (while in sinus rhythm). Left atrial (LA-GS) and left ventricular (LV-GS) global longitudinal strains were measured with 2D speckle tracking. Patients were followed for AF recurrence after CA. Results: During mean follow-up of 16±6 months, 44 patients (40%) had AF recurrence. LA-GS (dichotomized to > or < 24.5 %) predicted freedom from AF recurrence (p<0.001 ; Figure 1). Patients with AF recurrence had lower LA-GS (22% vs 31% ; p<0.001) and lower magnitude of LV-GS (-15.6% vs -17.4% ; p=0.001). ROC analysis revealed that LA-GS predicted AF recurrence better than LV-GS (AUC= 0.87 vs. 0.69 ; p=0.002) or LAVI (AUC=0.87 vs. 0.59 ; p<0.001). LA-GS <24.5% had 75% sensitivity and 91% specificity for predicting AF recurrence. By multivariate analysis, LA-GS entered either as a binary (<24.5%) (HR=8.91, 95% CI=4.35-18.27 ; p<0.001) or a continuous variable (HR=0.88, 95% CI=0.85-0.92 ; p<0.001) was the only independent predictor of AF recurrence. Conclusion: Left atrial strain by speckle tracking echocardiography is a strong and independent predictor of AF recurrence after CA therapy in patients with paroxysmal AF and preserved EF.

left atrial strain ; atrial fibrillation ; catheter ablation

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