Decreased left atrial global longitudinal strain predicts the risk of atrial fibrillation recurrence after cryoablation in paroxysmal atrial fibrillation

J Interv Card Electrophysiol. 2020 Jun;58(1):51-59. doi: 10.1007/s10840-019-00573-4. Epub 2019 Jun 10.

Abstract

Purpose: We aimed to investigate the association of atrial fibrillation (AF) recurrence with left atrial (LA) strain in nonvalvular paroxysmal AF patients after cryoablation.

Methods: We included 190 patients who underwent successful cryoablation due to paroxysmal AF. In addition to classical echocardiographic data, LA apical 2-chamber (A2C) strain, LA apical 4-chamber (A4C) strain, and LA global longitudinal strain (LA-GLS) values were calculated by speckle tracking echocardiography. Forty-eight-hour Holter monitoring was performed to all patients no later than 6 months after ablation.

Results: AF recurrence was detected in 42 patients (22.1%). End-systolic diameter, LA end-systolic diameter, LA-volume, LA-volume index, interatrial septum thickness, coronary sinus diameter, epicardial fat thickness (EFT), and septal E/E` ratio were significantly higher, LV-EF, IVRT, septal S and A` wave, lateral S wave, LA-A2C strain, LA-A4C strain, and LA-GLS were significantly lower in patients with AF recurrence. LA-GLS, LA-volume index, and EFT were found to be independent parameters for predicting AF recurrence.

Conclusions: LA-GLS and LAVI should be included in routine evaluations to determine long-term AF recurrence preoperatively.

Keywords: Cryoablation; Left atrial global longitudinal strain; Paroxysmal atrial fibrillation.

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Cryosurgery*
  • Echocardiography
  • Heart Atria / diagnostic imaging
  • Heart Atria / surgery
  • Humans
  • Recurrence
  • Reproducibility of Results