Decreased left atrial strain during the contraction phase independently predicted atrial tachyarrhythmia recurrence after catheter ablation (OR 1.06 per 1% decrease; 95% CI 1.02-1.11; p=0.007).
Cohort (n=678)
Does left atrial strain assessment by 2DSTE predict recurrence of atrial tachyarrhythmia in patients undergoing catheter ablation for atrial fibrillation?
Left atrial contractile strain measured by 2DSTE prior to catheter ablation is an independent predictor of atrial tachyarrhythmia recurrence, providing prognostic value even in patients with normal left atrial size.
Odds Ratio: 1.06 (95% CI 1.02–1.11)
p-value: p=0.007
BackgroundDespite improvement in treatment strategies of atrial fibrillation (AF), a considerable number of patients still experience recurrence of atrial tachyarrhythmia (ATA) following catheter ablation (CA). This study aimed to investigate the prognostic value of left atrial (LA) deformation analysis in a large group of patients undergoing CA for AF.MethodsThis study included 678 patients with AF. Echocardiography including two-dimensional speckle tracking echocardiography (2DSTE) was performed in all patients prior to CA. Logistic regression analysis was used to assess the association between ATA recurrence and LA strain during reservoir phase (LASr), LA strain during contraction phase (LASct), and LA strain during conduit phase (LAScd).ResultsDuring one-year follow-up, 274 (40%) experienced ATA recurrence. Median age of the included study population was 63.2 years (IQR: 55.5, 69.5) and 485 (72%) were male. Patients with recurrence had lower LASr (22.6% vs. 25.1%, p = 0.001) and LASct (10.7% vs. 12.4%, p < 0.001). No difference in LAScd was observed. After adjusting for potential clinical and echocardiographic confounders LASr (OR = 1.04, CI95% 1.01; 1.07, p = 0.015, per 1% decrease) and LASct (OR = 1.06, CI95% 1.02; 1.11, p = 0.007, per 1% decrease) remained independent predictors of recurrence. However, in patients with a normal-sized LA (LA volume index<34 mL/m2), only LASct remained an independent predictor of recurrence (OR = 1.07, CI95% 1.01; 1.12, p = 0.012, per 1% decrease).ConclusionIn patients undergoing CA for AF, LA deformation analysis by 2DSTE could be of use in risk stratification in clinical practice regarding ATA recurrence, even in patients with a normal-sized LA.
Nielsen et al. (Fri,) conducted a cohort in Atrial fibrillation (n=678). Left atrial strain during contraction phase (LASct) was evaluated on Recurrence of atrial tachyarrhythmia (ATA) (OR 1.06, 95% CI 1.02-1.11, p=0.007). Decreased left atrial strain during the contraction phase independently predicted atrial tachyarrhythmia recurrence after catheter ablation (OR 1.06 per 1% decrease; 95% CI 1.02-1.11; p=0.007).