What question did this study set out to answer?

March 6, 2015European Heart Journal - Cardiovascular ImagingOpen Access

Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation

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Why the study?

Does left atrial strain predict atrial fibrillation recurrence in patients undergoing catheter ablation?

Key Points

To identify echocardiographic predictors of atrial fibrillation recurrence in patients undergoing catheter ablation presenting with either sinus rhythm or active atrial fibrillation.
Evaluated 100 patients with paroxysmal (n=68) or persistent (n=32) atrial fibrillation undergoing catheter ablation, categorized by rhythm during transthoracic echocardiography into normal sinus rhythm (n=50) or atrial fibrillation (n=50).
Measured left atrial global strain and lateral total strain via two-dimensional speckle tracking echocardiography, alongside maximum left atrial volume index.
Tracked post-ablation recurrence over 12 months and identified predictors using multivariate logistic regression and receiver operating characteristic analyses.
Atrial fibrillation recurred in 26 of 100 patients (11 in normal sinus rhythm group, 15 in atrial fibrillation group) over 12 months of follow-up.
Patients with recurrence exhibited significantly longer arrhythmia duration, lower global strain, lower lateral total strain, and larger maximum volume index than non-recurrent patients.
Basal left atrial lateral total strain was the strongest independent predictor of recurrence across both rhythm cohorts (AUC: 0.84 vs. 0.74 for maximum volume index), while maximum volume index was an independent predictor only in the active fibrillation group.

Structured PICO

Does left atrial strain predict atrial fibrillation recurrence in patients undergoing catheter ablation?

Population

100 patients with symptomatic paroxysmal (n=68) or persistent (n=32) atrial fibrillation undergoing catheter ablation, with either sinus rhythm (n=50) or AF rhythm (n=50) during pre-procedural echocardiography.

Intervention

Left atrial strain measurement (specifically basal LA lateral total strain and LAVImax) by two-dimensional speckle tracking echocardiography

Outcome

Atrial fibrillation recurrence during 12 months of follow-up

Basal left atrial lateral total strain is a strong, independent predictor of AF recurrence after catheter ablation that can be reliably assessed even during AF rhythm.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May aid post-ablation AF recurrence stratification; leaves open prospective validation before practice change.

Cite This Study

Yasuda et al. (2015) studied this question.

synapsesocial.com/papers/6a71611de5469ee92be1ecb3 https://doi.org/10.1093/ehjci/jev028

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Echocardiography Anticoagulation in AF

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Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider