Key result
Higher left atrial appendage peak flow velocity was associated with a reduced risk of nonvalvular atrial fibrillation recurrence after initial cryoballoon ablation (HR 0.8 per 1 cm/s increase).
Why the study?
Whether the connection between left atrial appendage peak flow velocity and postoperative persistent AF recurrence generalizes to persistent AF patients undergoing initial cryoballoon ablation was unknown.
Does pre-procedural left atrial appendage peak flow velocity predict recurrence of atrial fibrillation in patients with persistent AF undergoing initial cryoballoon ablation?
Cohort (n=74)
No
Does pre-procedural left atrial appendage peak flow velocity predict recurrence of atrial fibrillation in patients with persistent AF undergoing initial cryoballoon ablation?
Hazard Ratio: 0.8 (95% CI 0.7–1)
p-value: p=0.011
A pre-procedural left atrial appendage peak flow velocity below 34.9 cm/s is an independent predictor of atrial fibrillation recurrence after initial cryoballoon ablation for persistent AF.
May help predict recurrence after first cryoballoon ablation in persistent AF; hypothesis-generating and needs prospective validation.
Background Previous studies revealed the connection between left atrial appendage peak flow velocity (LAA-PEV) and postoperative persistent atrial fibrillation (AF) recurrence. Yet, this association is not necessarily generalizable to persistent AF patients undergoing initial cryoballoon ablation due to current gaps in the literature. Methods We prospectively studied 74 consecutive individuals with persistent atrial fibrillation undergoing a cryoballoon ablation for the first time between January 2018 and January 2020. Before ablation, LAA-PEV was documented by transesophageal echocardiography (TEE). Subsequently, demographic information and other clinical characteristics of these participants were collected. A 96-h continuous cardiac monitor was reviewed regularly for recurrence of atrial fibrillation. Cox proportional hazards regression was used to investigate LAA-PEV as well as other clinical characteristics as a predictor of AF recurrence. Results Our study found that AF recurrences had lower LAA-PEV than those without AF recurrence. A nonlinear relationship between the LAA-PEV and AF recurrence was observed in this study, which had an inflection point of 34.9. Subgroup analysis of female participants showed that LAA-PEV had a positive correlation with AF recurrence [β = 0.8, 95% CI (0.7, 0.9), p < 0.05]. Conclusion A low LAA-PEV is related to recurrence of atrial fibrillation and may predict AF recurrence after initial cryoballoon ablation for persistent atrial fibrillation. This finding may help improve treatment and care strategies for patients with persistent atrial fibrillation.
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Wang et al. (2023) conducted a cohort in Nonvalvular persistent atrial fibrillation (n=74). Left atrial appendage peak flow velocity (LAA-PEV) vs. Lower LAA-PEV was evaluated on Recurrence of nonvalvular atrial fibrillation (HR 0.8, 95% CI 0.7-1.0, p=0.011). Higher left atrial appendage peak flow velocity was associated with a reduced risk of nonvalvular atrial fibrillation recurrence after initial cryoballoon ablation (HR 0.8 per 1 cm/s increase).
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