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Global left atrial strain in the prediction of sinus rhythm maintenance after catheter ablation for atrial fibrillation


Motoki, H and Negishi, K and Kusunose, K and Popovic, ZB and Bhargava, M and Wazni, OM and Saliba, WI and Chung, MK and Marwick, TH and Klein, AL, Global left atrial strain in the prediction of sinus rhythm maintenance after catheter ablation for atrial fibrillation, Journal of the American Society of Echocardiography, 27, (11) pp. 1184-1192. ISSN 0894-7317 (2014) [Refereed Article]

Copyright Statement

Copyright 2014 American Society of Echocardiography

DOI: doi:10.1016/j.echo.2014.08.017


BACKGROUND: Left atrial (LA) strain is a sensitive measure of LA mechanics. However, its relationship with rhythm outcomes after catheter ablation in patients with atrial fibrillation (AF) is not well established. The aim of this study was to evaluate whether baseline LA global longitudinal strain (LAε) predicts rhythm outcomes in patients who undergo catheter ablation for AF.

METHODS: In 256 patients with AF (paroxysmal, 204; persistent, 52), comprehensive echocardiography was performed with assessment of LAε by using Velocity Vector Imaging to calculate average strain values from apical four- and two-chamber views before ablation (median, 41 days; interquartile range, 1-95 days).

RESULTS: After a median of 8.0 months (interquartile range, 4.0-23.3 months) of follow-up, 149 patients (58%) had maintained sinus rhythm and 107 patients (42%) had recurrence of AF. In our study cohort (mean age 59 11 years; mean left ventricular ejection fraction, 58 10%), impaired total LAε (LAεtotal) was associated with greater left ventricular mass index (r = -0.245, P < .001) and worsening left ventricular diastolic function (ratio of transmitral flow peak early diastolic velocity to peak early diastolic velocity of the mitral annulus: r = -0.357, P < .001; maximal LA volume index: r = -0.393, P < .001). Patients with LAεtotal < 23.2% showed a higher incidence of AF recurrence compared with patients with LAεtotal ≥ 23.2% (log-rank P < .001). In multivariate Cox proportional-hazards analysis, LAεtotal was independently related to rhythm outcomes (hazard ratio, 0.944; 95% confidence interval, 0.915-0.975; P < .001) after AF ablation. Moreover, LAεtotal provided incremental predictive value for rhythm outcomes over clinical features (increment in global χ(2) = 14.63, P < .001).

CONCLUSIONS: In patients with AF, baseline LAεtotal was associated with rhythm outcome after catheter ablation.

Item Details

Item Type:Refereed Article
Keywords:Atrial fibrillation; Atrial function; Catheter ablation; Echocardiography
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:97322
Year Published:2014
Web of Science® Times Cited:75
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-12-11
Last Modified:2017-11-01

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