Title

Association of Left Atrial Function Index With Late Atrial Fibrillation Recurrence after Catheter Ablation

UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine

Date

12-1-2016

Document Type

Article

Disciplines

Cardiology | Cardiovascular Diseases | Translational Medical Research

Abstract

INTRODUCTION: Although catheter ablation (CA) for atrial fibrillation (AF) is commonly used to improve symptoms, AF recurrence is common and new tools are needed to better inform patient selection for CA. Left atrial function index (LAFI), an echocardiographic measure of atrial mechanical function, has shown promise as a noninvasive predictor of AF. We hypothesized that LAFI would relate to AF recurrence after CA.

METHODS AND RESULTS: All AF patients undergoing index CA were enrolled in a prospective institutional AF Treatment Registry between 2011 and 2014. LAFI was measured post hoc from pre-ablation clinical echocardiographic images in 168 participants. Participants were mostly male (33% female), middle-aged (60 +/- 10 years), obese and had paroxysmal AF (64%). Mean LAFI was 25.9 +/- 17.6. Over 12 months of follow-up, 78 participants (46%) experienced a late AF recurrence. In logistic regression analyses adjusting for factors known to be associated with AF, lower LAFI remained associated with AF recurrence after CA [OR 0.04 (0.01-0.67), P = 0.02]. LAFI discriminated AF recurrence after CA slightly better than CHADS2 (C-statistic 0.60 LAFI, 0.57 CHADS2). For participants with persistent AF, LAFI performed significantly better than CHADS2 score (C statistic = 0.79 LAFI, 0.56 CHADS2, P = 0.02).

CONCLUSION: LAFI, an echocardiographic measure of atrial function, is associated with AF recurrence after CA and has improved ability to discriminate AF recurrence as compared to the CHADS-2 score, especially among persistent AF patients. Since LAFI can be calculated using standard 2D echocardiographic images, it may be a helpful tool for predicting AF recurrence.

Rights and Permissions

Citation: J Cardiovasc Electrophysiol. 2016 Dec;27(12):1411-1419. doi: 10.1111/jce.13086. Epub 2016 Oct 7. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Keywords

UMCCTS funding

PubMed ID

27569695