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

Risako Yasuda, Mitsushige Murata, Rachel Roberts, Hanako Tokuda, Yugo Minakata, Keiko Suzuki, Hikaru Tsuruta, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoshiyasu Aizawa, Kojiro Tanimoto, Seiji Takatsuki, Takayuki Abe, Keiichi Fukuda

Research output: Contribution to journalArticle

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Abstract

AIMS: Accumulating data show the efficacy of catheter ablation (CA) for atrial fibrillation (AF); however, postoperative recurrence is not uncommon. The aim of this study was to identify predictors of AF recurrence in patients undergoing CA.

METHODS AND RESULTS: We studied 100 patients with symptomatic paroxysmal (68) or persistent (32) AF who underwent CA preceded by transthoracic echocardiographic examination. Of these, 50 had sinus rhythm during echocardiography (Group NSR) and 50 had AF rhythm (Group AF). The left atrial (LA) strain was measured by two-dimensional speckle tracking echocardiography. Echocardiographic parameters were compared between the patients with AF recurrence and no recurrence. During 12 months of follow-up, 26 of 100 patients (11 in Group NSR and 15 in Group AF) had AF recurrence; these patients had significantly longer AF duration, a lower LA global strain (LA-GS), lower LA lateral total strain (LA-LS), and larger maximum LA volume index (LAVImax) than those who maintained sinus rhythm. Multivariate logistic regression identified basal LA-LS and LAVImax as independent predictors of AF recurrence. Furthermore, receiver operating characteristic analyses revealed that basal LA-LS was the most useful parameter for predicting AF recurrence [area under the curve (AUC): 0.84 vs. 0.74 in LAVImax]. Subanalyses showed that LAVImax was another independent predictor of AF recurrence in Group AF, but not in Group NSR, while basal LA-LS was a significant predictor in both groups.

CONCLUSION: LA myocardial function assessed by basal LA-LS could predict AF recurrence after CA. Notably, such an assessment could be applicable even during AF rhythm, suggesting its convenience in the clinical setting without defibrillation before analysis.

Original languageEnglish
Pages (from-to)1008-1014
Number of pages7
JournalEuropean Heart Journal Cardiovascular Imaging
Volume16
Issue number9
DOIs
Publication statusPublished - 2015 Sep 1

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Catheter Ablation
Atrial Fibrillation
Recurrence
Population
Echocardiography
Left Atrial Function
ROC Curve
Area Under Curve

Keywords

  • atrial fibrillation
  • catheter ablation
  • LA strain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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. / Yasuda, Risako; Murata, Mitsushige; Roberts, Rachel; Tokuda, Hanako; Minakata, Yugo; Suzuki, Keiko; Tsuruta, Hikaru; Kimura, Takehiro; Nishiyama, Nobuhiro; Fukumoto, Kotaro; Aizawa, Yoshiyasu; Tanimoto, Kojiro; Takatsuki, Seiji; Abe, Takayuki; Fukuda, Keiichi.

In: European Heart Journal Cardiovascular Imaging, Vol. 16, No. 9, 01.09.2015, p. 1008-1014.

Research output: Contribution to journalArticle

Yasuda, Risako ; Murata, Mitsushige ; Roberts, Rachel ; Tokuda, Hanako ; Minakata, Yugo ; Suzuki, Keiko ; Tsuruta, Hikaru ; Kimura, Takehiro ; Nishiyama, Nobuhiro ; Fukumoto, Kotaro ; Aizawa, Yoshiyasu ; Tanimoto, Kojiro ; Takatsuki, Seiji ; Abe, Takayuki ; Fukuda, Keiichi. / 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. In: European Heart Journal Cardiovascular Imaging. 2015 ; Vol. 16, No. 9. pp. 1008-1014.
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T2 - study of a heterogeneous population with sinus rhythm or atrial fibrillation

AU - Yasuda, Risako

AU - Murata, Mitsushige

AU - Roberts, Rachel

AU - Tokuda, Hanako

AU - Minakata, Yugo

AU - Suzuki, Keiko

AU - Tsuruta, Hikaru

AU - Kimura, Takehiro

AU - Nishiyama, Nobuhiro

AU - Fukumoto, Kotaro

AU - Aizawa, Yoshiyasu

AU - Tanimoto, Kojiro

AU - Takatsuki, Seiji

AU - Abe, Takayuki

AU - Fukuda, Keiichi

PY - 2015/9/1

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N2 - AIMS: Accumulating data show the efficacy of catheter ablation (CA) for atrial fibrillation (AF); however, postoperative recurrence is not uncommon. The aim of this study was to identify predictors of AF recurrence in patients undergoing CA.METHODS AND RESULTS: We studied 100 patients with symptomatic paroxysmal (68) or persistent (32) AF who underwent CA preceded by transthoracic echocardiographic examination. Of these, 50 had sinus rhythm during echocardiography (Group NSR) and 50 had AF rhythm (Group AF). The left atrial (LA) strain was measured by two-dimensional speckle tracking echocardiography. Echocardiographic parameters were compared between the patients with AF recurrence and no recurrence. During 12 months of follow-up, 26 of 100 patients (11 in Group NSR and 15 in Group AF) had AF recurrence; these patients had significantly longer AF duration, a lower LA global strain (LA-GS), lower LA lateral total strain (LA-LS), and larger maximum LA volume index (LAVImax) than those who maintained sinus rhythm. Multivariate logistic regression identified basal LA-LS and LAVImax as independent predictors of AF recurrence. Furthermore, receiver operating characteristic analyses revealed that basal LA-LS was the most useful parameter for predicting AF recurrence [area under the curve (AUC): 0.84 vs. 0.74 in LAVImax]. Subanalyses showed that LAVImax was another independent predictor of AF recurrence in Group AF, but not in Group NSR, while basal LA-LS was a significant predictor in both groups.CONCLUSION: LA myocardial function assessed by basal LA-LS could predict AF recurrence after CA. Notably, such an assessment could be applicable even during AF rhythm, suggesting its convenience in the clinical setting without defibrillation before analysis.

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