Association of peak atrial longitudinal strain with atrial fibrillation recurrence in patients with chronic lung diseases following radiofrequency ablation

BACKGROUND: Strain was shown associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA), but data on AF patients complicated with chronic lung diseases (CLD) were rare. AIM: This study was designed to evaluate the relationship of baseline atrial function with AF recurrence in these patients using speckle-tracking echocardiography. METHODS: Average strain values (median: 2 days before RFA) were calculated for 87 AF patients (Mean age: 61.91 years, male: 71.26%) with CLD undergoing RFA from 2013 to 2014. Of these patients, 25 (28.74%) experienced AF recurrence during a mean follow up of 10.3 months. RESULTS: Peak right atrial longitudinal strain (R-PALS) was associated with peak left atrial longitudinal strain (L-PALS, Standardised β = 0.45, P < 0.001) in multivariate linear regression. Multivariate Cox regression analysis showed R-PALS was associated with AF recurrence (hazard ratio, 0.86; 95% confidence interval (CI), 0.78-0.96, P = 0.005) in CLD. Patients with R-PALS ≥14.69% had higher AF free rate compared with R-PALS<14.69% using Kaplan-Meier analysis (log-rank, P < 0.001). R-PALS had similar C-index compared to L-PALS (difference: 0.03, 95%CI: -0.06-0.12, P = 0.53) and combined R-PALS and L-PALS (difference: 0.005, 95%CI: -0.04-0.05, P = 0.84) associated with AF recurrence in CLD. CONCLUSION: R-PALS, L-PALS and combined R-PALS and L-PALS are important factors associated with AF recurrence following RFA in patients with CLD.