Do left atrial structure and function indices predict recurrence of atrial fibrillation after catheter ablation?
Echocardiographic indices of left atrial structure and function, specifically LA strain <19%, LA diameter ≥50 mm, and LA volume >150 ml, are strong predictors of atrial fibrillation recurrence following catheter ablation.
BACKGROUND: Catheter ablation (CA) has become a conventional treatment for atrial fibrillation (AF), but remains with high recurrence rate. The aim of this meta-analysis was to determine left atrial (LA) structure and function indices that predict recurrence of AF. METHODS: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to September 2017 in order to select clinical trials and observational studies which reported echocardiographic predictors of AF recurrence after CA. Eighty-five articles with a total of 16 126 patients were finally included. RESULTS: The pooled analysis showed that after a follow-up period of 21 ± 12 months, patients with AF recurrence had larger LA diameter with weighted mean difference (WMD: 2·99 (95% CI 2·50-3·47, P150 ml (OR: 2·25, 95% CI, 1.1-5·6, P = 0·0002). CONCLUSIONS: Based on this meta-analysis results, a dilated left atrium with diameter more than 50 mm and volume above 150 ml or myocardial strain below 19% reflect an unstable LA that is unlikely to hold sinus rhythm after catheter ablation for atrial fibrillation.
Bajraktari et al. (Thu,) studied this question.