Left atrial contractile strain predicts recurrence of atrial tachyarrhythmia after catheter ablation
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Left atrial contractile strain predicts recurrence of atrial tachyarrhythmia after catheter ablation. / Nielsen, Anne Bjerg; Skaarup, Kristoffer Grundtvig; Djernæs, Kasper; Hauser, Raphael; San José Estépar, Raúl; Sørensen, Samuel Kiil; Ruwald, Martin Huth; Hansen, Morten Lock; Worck, René Husted; Johannessen, Arne; Hansen, Jim; Biering-Sørensen, Tor.
I: International Journal of Cardiology, Bind 358, 2022, s. 51-57.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Left atrial contractile strain predicts recurrence of atrial tachyarrhythmia after catheter ablation
AU - Nielsen, Anne Bjerg
AU - Skaarup, Kristoffer Grundtvig
AU - Djernæs, Kasper
AU - Hauser, Raphael
AU - San José Estépar, Raúl
AU - Sørensen, Samuel Kiil
AU - Ruwald, Martin Huth
AU - Hansen, Morten Lock
AU - Worck, René Husted
AU - Johannessen, Arne
AU - Hansen, Jim
AU - Biering-Sørensen, Tor
N1 - Publisher Copyright: © 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Left atrial strain
KW - Speckle tracking echocardiography
UR - http://www.scopus.com/inward/record.url?scp=85129703175&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2022.04.056
DO - 10.1016/j.ijcard.2022.04.056
M3 - Journal article
C2 - 35469934
AN - SCOPUS:85129703175
VL - 358
SP - 51
EP - 57
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 311123324