The association between left atrial appendage emptying velocity and atrial fibrillation recurrence after radiofrequency catheter ablation in patients with early persistent atrial fibrillation

OBJECTIVE: In the present study, we aimed to explore the association between left atrial appendage emptying velocity (LAAEV) measured by transesophageal echocardiography and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) in patients with early persistent atrial fibrillation (PeAF). METHODS: We retrospectively analyzed patients with early PeAF who underwent their initial ablation procedure. The echocardiographic and clinical data of the enrolled patients were collected and recorded prior to the operation. Following adjustment for confounding factors, we investigated the relationship between the LAAEV and AF recurrence in patients with early PeAF after radiofrequency ablation. RESULTS: The proportions of AF recurrence in the low, medium, and high LAAEV groups were 48.8%, 16.0%, and 13.1%, respectively. After adjusting for potential confounding factors, we observed a gradual decrease in the risk of AF recurrence with increasing LAAEV (odds ratio: 0.882, 95% confidence interval: 0.842-0.924, p<0.001). This trend was statistically significant (p<0.001), particularly when comparing the high and low LAAEV groups (odds ratio: 0.033, 95% confidence interval: 0.009-0.116, p<0.001). Curve fitting analysis demonstrated an approximate negative linear association between LAAEV and the probability of AF recurrence. CONCLUSIONS: Among patients with early PeAF who successfully underwent their first RFCA, we found that the LAAEV within 24 h before the procedure was independently correlated with the risk of AF recurrence. Notably, this association was negative, indicating that higher LAAEV was associated with a lower risk of AF recurrence.