Catheter ablation for atrial fibrillation improved bi-atrial function, with post-procedural right atrial reservoir strain independently predicting AF/AT recurrence (HR 0.94; 95% CI 0.89-0.99; P=0.016).
Observational (n=81)
Does catheter ablation for atrial fibrillation improve bi-atrial strain and predict AF/AT recurrence in patients with AF?
Catheter ablation for atrial fibrillation leads to significant bi-atrial functional recovery, with right atrial improvement exceeding left atrial improvement, and post-procedural strain serves as an independent predictor of arrhythmia recurrence.
Effect estimate: HR 0.94 (95% CI 0.89-0.99)
p-value: p=0.016
BACKGROUND Catheter ablation for atrial fibrillation (AF) can improve atrial function; however, little is known about chamber-specific remodeling between the left (LA) and right (RA) atria. OBJECTIVE We investigated the differences in bi-atrial strain and its predictive value for atrial tachyarrhythmias (AF/AT) recurrence. METHODS We retrospectively analyzed the patients undergoing initial AF ablation who underwent pre- and post-procedural echocardiography. Atrial strain was quantified by two-dimensional speckle-tracking echocardiography. RESULTS Eighty-one patients were analyzed. Both the mean LA (LASr: 15.3 ± 10.0 to 19.9 ± 8.2%) and RA (RASr: 18.3 ± 10.8 to 27.3 ± 9.3%) reservoir strain improved significantly after AF ablation (P<0.001 for both), with a greater improvement in RASr than LASr (ΔRASr: 9.0 ± 10.7% vs. ΔLASr: 4.5 ± 8.4%, P<0.001). Moreover, whereas LA conduit strain did not change significantly (-9.3 ± 5.6 to -10.3 ± 4.4%, P=0.071), RA conduit strain improved significantly (-10.3 ± 6.3 to -14.1 ± 6.2%, P<0.001). Post-procedural LASr (HR 0.92, 95%CI: 0.85-1.0, P=0.049) and RASr (HR 0.94, 95%CI:0.89-0.99, P=0.016) were independent predictors of AF/AT recurrence. ROC analysis yielded similar discriminative ability for LASr (area under the curve (AUC): 0.75, cut-off value: 20.0%) and RASr (AUC: 0.69, cut-off value: 27.0%) (P=0.367). CONCLUSION AF ablation led to significant bi-atrial functional recovery, with RA improvement exceeding that of LA. Both post-procedural LASr and RASr independently predicted AF/AT recurrence, supporting chamber-specific atrial strain as a sensitive marker of reverse remodeling and procedural outcome.
Tachibana et al. (Sun,) conducted a observational in Atrial fibrillation (AF) (n=81). Catheter ablation was evaluated on AF/AT recurrence predicted by post-procedural right atrial reservoir strain (RASr) (HR 0.94, 95% CI 0.89-0.99, p=0.016). Catheter ablation for atrial fibrillation improved bi-atrial function, with post-procedural right atrial reservoir strain independently predicting AF/AT recurrence (HR 0.94; 95% CI 0.89-0.99; P=0.016).