scholarly journals Value of Left Atrial Appendage Function Measured by Transesophageal Echocardiography for Prediction of Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1465
Author(s):  
Sabina Istratoaie ◽  
Ștefan C. Vesa ◽  
Gabriel Cismaru ◽  
Dana Pop ◽  
Radu Roșu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Radiofrequency Catheter Ablation ◽  
Left Atrial Appendage ◽  
Independent Predictor ◽  
Atrial Appendage ◽  
Recurrence Group ◽  
Af Recurrence

Atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) remains a challenging issue. This study aims to explore the left atrial appendage function by transesophageal echocardiography (TEE) and assess its value in predicting AF recurrence following RFCA in paroxysmal AF patients. Eighty-one patients with paroxysmal AF that underwent RFCA were recruited. TEE was performed before ablation with the assessment of left atrial appendage emptying flow velocity (LAAeV). AF recurrence occurred in 24 patients (29.6%) within 12 months after RFCA. The left atrium diameter (LAD) and left atrium volume index (LAVI) were both significantly higher in the recurrence group compared to the non-recurrence group, while the LAAeV was significantly lower in the recurrence group. LAD, LAVi and LAAeV were univariately significant risk factors for AF recurrence after ablation. Based on receiver operating curve (ROC), LAAeV < 40.5 cm/s, LAVi > 40.5 mL and LAD > 41 mm were identified as cut-off values for predicting AF recurrence. In multivariate regression analysis LAAeV < 40.5 cm/s (HR 8.194, 95% CI 2.980–22.530, p < 0.001) was identified as the only statistically significant independent predictor of AF recurrence, as the statistical significance threshold was not achieved for LAVI > 40.5 mL and LAD > 41 mm (p = 0.319; p = 0.507, respectively). A low LAAeV was the only important independent predictor of AF recurrence within 1 year after first RFCA.

scholarly journals Incremental predictive value of left atrial strain and left atrial appendage function in rhythm outcome of non-valvular atrial fibrillation patients after catheter ablation

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001635
Author(s):  
Xin-Xin Ma ◽  
Aiqing Wang ◽  
Kaibin Lin
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Global Longitudinal Strain ◽  
Predictive Performance ◽  
Atrial Appendage ◽  
Left Atrial Strain ◽  
Internal Validation ◽  
Af Recurrence

ObjectiveThe purpose of this study was to develop a non-invasive and convenient nomogram based on speckle tracking echocardiography, left atrial appendage function and clinical factors to predict the risk of atrial fibrillation (AF) recurrence after catheter ablation.MethodsA total of 124 prospectively consecutive patients with AF treated with catheter ablation in our hospital was retrospectively analysis. Baseline echocardiographic parameters were measured by using transthoracic and transesophageal echocardiography before ablation. Multivariate analysis was performed for selecting predictors for a nomogram and internal validation and calibration were evaluated by the bootstep method.ResultsDuring the follow-up of 12±3 months, 41 patients (33.1%) occurred AF recurrence after catheter ablation, while 83 patients (66.9%) had maintained sinus rhythm. Four predictors (AF type, left atrial appendage emptying flow velocity, left Atrial maximal volumes index and global longitudinal strain) with the P<0.5 was selected into the nomogram according to multivariate findings. Internal validation by bootstrapping with 1000 resamples was determined C-index of the nomogram for prediction AF recurrence was 0.901, which showed optimal discrimination and calibration of the established nomogram.ConclusionsNomogram based on echocardiography and clinical characteristics had good predictive performance for the possibility of AF recurrence, which providing practical guidance for individualised management of patients with AF after catheter ablation.

scholarly journals The Predictive Value of left atrial appendage peak flow velocity in Recurrence after initial radiofrequency catheter ablation of persistent atrial fibrillation: A single-center prospective study.

2021 ◽  
Author(s):  
Wentao Yang ◽  
Qing Zhao ◽  
Minghui Yao ◽  
Xiangdong Li ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Radiofrequency Catheter Ablation ◽  
Left Atrial Appendage ◽  
Peak Flow ◽  
Persistent Atrial Fibrillation ◽  
Af Recurrence

Background: Recurrence after Radiofrequency catheter ablation（RFCA） of persistent atrial fibrillation (PeAF) is still elusive. The present study aimed to evaluate the relationship between the left atrial appendage peak flow velocity(LAAV) and atrial fibrillation(AF) recurrences in PeAF patients after their initial RFCA. Method: This study included 164 consecutive PeAF patients who performed initial RFCA from January 2018 to December 2019. Transesophageal echocardiography was used to collect the LAAV before ablation. Patients’ demographic and clinical information was gathered. To detect the recurrences of AF, patients were checked up at routine intervals. A Cox proportional hazards regression analysis was adopted to evaluate the LAAV and other clinical variables as predictors of AF recurrences throughout follow-up. Results: AF recurrence resulted in 43 (26.2%) patients after a median follow-up of 15 months (IQR: 12-18 months). LAAV reduced in patients with AF recurrences (0.36±0.15m/s vs. 0.45±0.17m/s, P = 0.004). A Kaplan-Meier study revealed that the low LAAV(≤0.37m/s) group had a lower event-free survival rate than the high LAAV (>0.37m/s) group (17.6 months vs. 21.2 months, Log Rank P = 0.002). LAAV≤0.37m/s (HR 2.32, 95%CI 1.177-4.227, P = 0.014) was found to be independent predictors of AF recurrence after RFCA in the multivariate Cox regression. Conclusion: A low LAAV is linked to AF recurrence and acts as a predictor of AF recurrence after the initial RFCA of peAF. This would aid in treatment strategy optimization and management of patients with peAF.

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