Introduction:
The present of left ventricular hypertrophy (LVH) or LVH with strain pattern on electrocardiogram (ECG) are independently predictors of new-onset atrial fibrillation (AF).
Hypothesis:
We assessed the hypothesis that LVH with or without strain can predict recurrence after radiofrequency catheter ablation (RFCA) of AF in paroxysmal atrial fibrillation (PAF) patients.
Methods:
436 PAF patients undergoing RFCA were enrolled and clustered into 3 subgroups: Non-LVH (218 patients), LVH (182 patients), LVH with strain (36 patients). LVH was characterized by the Romhilt-Estes point system and ECG strain was defined as ST-segment depression≥1-mm and T-wave inversion≥1 mm in the lateral leads.
Results:
After 42 (interquartile range, 18.0 to 60.0 months) months follow-up period with a median of 1 (1 to 3) RFCA procedure, sinus rhythm was maintained in 248 patients (60.2%) without antiarrhythmic drugs. Patients with LVH (79, 43.6%) and LVH with strain (22, 62.9%) tended to experience much higher AF episodes recurrence ratio compared to those with non-LVH (71, 33.3%; P=0.000). In multivariate analysis after adjustment for age, sex, CHA2SDVAS score and left atrial diameter (LAD), the present of LVH with strain was the only independent risk factor of AF recurrence (95%CI: 1.242 to 5.808, P=0.012).
Conclusions:
That present of LVH with strain but not LVH alone is a strong and independent predictor of AF recurrence in PAF patients following RFCA.
Electrocardiographic left ventricular hypertrophy predicts recurrence of atrial arrhythmias after catheter ablation of paroxysmal atrial fibrillation
