Key result
A left atrial appendage peak flow velocity <0.37 m/s independently predicted atrial fibrillation recurrence following first radiofrequency catheter ablation (HR 2.32; 95% CI 1.177-4.227; P=0.014).
Why the study?
AF relapse following radiofrequency catheter ablation for persistent AF remains a concern, motivating evaluation of whether left atrial appendage peak flow velocity predicts recurrence.
Does low left atrial appendage peak flow velocity predict the recurrence of atrial fibrillation in patients with persistent AF undergoing first radiofrequency catheter ablation?
Cohort (n=164)
Does low left atrial appendage peak flow velocity predict the recurrence of atrial fibrillation in patients with persistent AF undergoing first radiofrequency catheter ablation?
Hazard Ratio: 2.32 (95% CI 1.177–4.227)
p-value: p=0.014
A low left atrial appendage peak flow velocity (<0.37 m/s) measured by TEE prior to first radiofrequency catheter ablation is an independent predictor of atrial fibrillation recurrence in patients with persistent AF.
May support post-ablation recurrence risk stratification in AF; hypothesis-generating for prospective validation before clinical use.
Background: Atrial fibrillation (AF) relapse following radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (PeAF) continues to be a concern. This study establishes a connection between left atrial appendage peak flow velocity (LAAV) and recurrence of AF in individuals having PeAF following first RFCA. Methods: We retrospectively studied 164 successive PeAF patients who had first RFCA between January 2018 and December 2019. Before the ablation, the LAAV was recorded using transesophageal echocardiography (TEE). The demographic and clinical data of the individuals were gathered. Participants were monitored at regular intervals to monitor for recurrence of AF. We employed Cox proportional hazards regression to determine if LAAV, as well as other clinical indicators, were predictive of AF recurrence in follow-up. Results: In this study, AF relapse was seen in 43 patients (26.2%) following a median follow-up of 15 [interquartile range (IQR): 12–18] months. It was shown that the LAAV was decreased in individuals who had recurrences of AF (0.36±0.05 vs. 0.45±0.17 m/s, P=0.004). Using Kaplan-Meier analysis, it was discovered that the low LAAV (0.37 m/s) group had a poorer event-free survival rate compared to the high LAAV (>0.37 m/s) group (17.6 vs. 21.2 months, log-rank P=0.002) group. Based on the results of the multivariate Cox regression analysis, a LAAV of fewer than 0.37 m/s [hazard ratio (HR): 2.32; 95% confidence interval (CI): 1.177–4.227; P=0.014] was shown to be an independent predictor of AF recurrence following RFCA. Conclusions: A low LAAV is associated with AF relapse, and it is a predictor of AF relapse following the first RFCA for PeAF. This discovery may be useful in the optimization of treatment strategies and the care of patients with PeAF.
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Yang et al. (2021) conducted a cohort in Persistent atrial fibrillation (n=164). Low left atrial appendage peak flow velocity (<0.37 m/s) vs. High left atrial appendage peak flow velocity (>0.37 m/s) was evaluated on Atrial fibrillation recurrence (HR 2.32, 95% CI 1.177-4.227, p=0.014). A left atrial appendage peak flow velocity <0.37 m/s independently predicted atrial fibrillation recurrence following first radiofrequency catheter ablation (HR 2.32; 95% CI 1.177-4.227; P=0.014).
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