Elevated mitral E/e′ and right ventricular systolic pressure at 3 months post-ablation independently predicted atrial tachyarrhythmia recurrence (HR 1.246 and 1.111, respectively).
Cohort (n=165)
No
Do early post-ablation hemodynamic echocardiographic parameters predict atrial tachyarrhythmia recurrence in patients undergoing de novo AF ablation?
Assessment of left ventricular diastolic function (E/e' and RVSP) at 3 months post-ablation serves as a more significant predictor of atrial fibrillation recurrence than left atrial strain.
Effect estimate: HR 1.246 (95% CI 1.048-1.482)
p-value: p=0.013
BACKGROUND: Atrial fibrillation (AF) recurrence after ablation requires predictors for better management. This study evaluated early post-ablation changes in echocardiographic parameters, clarifying the relative importance of left ventricle (LV) diastolic function and left atrium (LA) strain for recurrence prediction. METHODS AND RESULTS: The study prospectively enrolled 165 consecutive patients undergoing de novo AF ablation between 2019 and 2021. Echocardiography was performed before and 3 months after ablation. Three months after ablation, LA volume and LA strain (reservoir and contraction phases) decreased significantly and the LV ejection fraction improved. Extrapulmonary vein LA ablation was associated with significantly lower LA strain at 3 months. Over a median follow-up of 359 days, atrial tachyarrhythmia recurred in 45 (27.3%) patients. Three months after ablation, there was no significant difference in LA strain between groups with and without recurrence, but mitral E/e' and right ventricular systolic pressure (RVSP) were significantly higher in the group with recurrence (mitral E/e' 7.4±2.2 vs. 10.4±4.1; RVSP 23.1±3.5 vs. 28.4±4.8 mmHg; P<0.001 for both). Multivariable analysis identified E/e' and RVSP at 3 months as independent predictors of recurrence (hazard ratios 1.246 and 1.111, respectively), but not LA strain. CONCLUSIONS: Following AF ablation, hemodynamic factors appear to be more significant predictors of recurrence than LA strain. Assessment of LV diastolic function during the early post-ablation period may help identify patients at high risk of recurrence.
Kim et al. (2025) conducted a cohort in Atrial fibrillation (n=165). Catheter ablation was evaluated on Atrial tachyarrhythmia recurrence (HR 1.246, 95% CI 1.048-1.482, p=0.013). Elevated mitral E/e′ and right ventricular systolic pressure at 3 months post-ablation independently predicted atrial tachyarrhythmia recurrence (HR 1.246 and 1.111, respectively).