Assessment of left atrial function and dyssynchrony by real time three-dimensional echocardiography predicts recurrence of paroxysmal atrial fibrillation after radiofrequency ablation.

OBJECTIVE: Left atrial volume and function are associated with recurrence of paroxysmal atrial fibrillation (AF) after radiofrequency ablation. A relationship between left atrial mechanical dyssynchrony and AF recurrence is presently unclear. The aim of this study was to investigate whether left atrial volume, function, and dyssynchrony were associated with AF recurrence in patients with normal left ventricular function, and normal or mildly enlarged left atrium, if assessed by the Real-time three-dimensional echocardiography (3DE). PATIENTS AND METHODS: We included 88 patients with AF who had their first pulmonary vein isolation. There were 67 patients without and 21 patients with AF recurrence after radiofrequency ablation. Real-time 3DE was performed in the sinus rhythm the day before radiofrequency ablation. Left atrial volumes (maximum, minimum and preA), functions (passive, active and reservoir) and dyssynchrony were calculated. The latter was quantified by the standard deviation of time to minimum systolic volume (Tmsv-SD) from the end-diastole. RESULTS: There was no difference between left atrial volume and function in patients with or without AF recurrence. However, significant differences in left atrial Tmsv-SD were observed in patients with AF recurrence. CONCLUSIONS: In patients with normal left ventricular function, and normal/mildly enlarged left atrium, left atrial Tmsv-SD assessment by Real-time 3DE is a useful predictor of AF recurrence after radiofrequency ablation.