Left atrial contractile strain predicts recurrence of atrial tachyarrhythmia after catheter ablation

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Background: Despite improvement in treatment strategies of atrial fibrillation (AF), a considerable number of patients still experience recurrence of atrial tachyarrhythmia (ATA) following catheter ablation (CA). This study aimed to investigate the prognostic value of left atrial (LA) deformation analysis in a large group of patients undergoing CA for AF. Methods: This study included 678 patients with AF. Echocardiography including two-dimensional speckle tracking echocardiography (2DSTE) was performed in all patients prior to CA. Logistic regression analysis was used to assess the association between ATA recurrence and LA strain during reservoir phase (LASr), LA strain during contraction phase (LASct), and LA strain during conduit phase (LAScd). Results: During one-year follow-up, 274 (40%) experienced ATA recurrence. Median age of the included study population was 63.2 years (IQR: 55.5, 69.5) and 485 (72%) were male. Patients with recurrence had lower LASr (22.6% vs. 25.1%, p = 0.001) and LASct (10.7% vs. 12.4%, p < 0.001). No difference in LAScd was observed. After adjusting for potential clinical and echocardiographic confounders LASr (OR = 1.04, CI95% [1.01; 1.07], p = 0.015, per 1% decrease) and LASct (OR = 1.06, CI95% [1.02; 1.11], p = 0.007, per 1% decrease) remained independent predictors of recurrence. However, in patients with a normal-sized LA (LA volume index<34 mL/m2), only LASct remained an independent predictor of recurrence (OR = 1.07, CI95% [1.01; 1.12], p = 0.012, per 1% decrease). Conclusion: In patients undergoing CA for AF, LA deformation analysis by 2DSTE could be of use in risk stratification in clinical practice regarding ATA recurrence, even in patients with a normal-sized LA.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cardiology
Vol/bind358
Sider (fra-til)51-57
ISSN0167-5273
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work was supported by the Independent Research Fund Denmark [grant number 9058-00043B]; the Novo Nordisk Foundation [grant number NNF19OC0056536]; and the Foundation of 17-12-1981. The sponsors had no role in the study design, data collection, data analysis, data interpretation, or writing of the article.

Funding Information:
Tor Biering-Sørensen is a steering committee member of the Amgen-financed GALACTIC-HF trial. He has received research grants from Sanofi Pasteur and GE healthcare. Additionally, he is a member of an advisory board in Sanofi Pasteur and Amgen and has received a speaker honorarium from Sanofi Pasteur and Novartis.

Publisher Copyright:
© 2022 The Author(s)

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