Cargando…
Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation
Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462594/ https://www.ncbi.nlm.nih.gov/pubmed/34559133 http://dx.doi.org/10.1097/MD.0000000000027278 |
_version_ | 1784572233129132032 |
---|---|
author | Pilichowska-Paszkiet, Ewa Baran, Jakub Kułakowski, Piotr Zaborska, Beata |
author_facet | Pilichowska-Paszkiet, Ewa Baran, Jakub Kułakowski, Piotr Zaborska, Beata |
author_sort | Pilichowska-Paszkiet, Ewa |
collection | PubMed |
description | Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of various LA function parameters. We aimed to assess the value of detailed evaluations of LA function using STE in patients with non-valvular AF without structural heart disease to predict the outcomes after CA for AF. Secondary aim was to analyze the prediction of CA efficacy in patients with normal LA dimension in baseline echocardiography. We studied with transthoracic and transesophageal echocardiography 82 patients (58% males, mean age 57.3 ± 9.5 years) with non-valvular paroxysmal AF without structural heart disease scheduled for CA. Peak longitudinal LA strain (LAS) and strain rate (LASR) during the reservoir (r), conduit (cd) and contraction (ct) phases were measured by STE before the procedure. Patients were followed for 1 year using serial 4 to 7 day Holter ECG monitoring. Complete freedom from any AF recurrence was achieved in 44 (54%) patients. All patients had normal left ventricular systolic and diastolic function and 53 (65%) of them had not enlarged LA. In the multivariable logistic regression analysis, global left atrial reservoir strain (LASr) was identified as an independent predictor of CA efficacy (OR [95% CI]: 1.35 [1.17–1.55], P < .0001). The opportunity of CA success was 135 fold higher for each 1% increase in global LASr. The receiver operating characteristic (ROC) analysis identified global LASr and left atrial conduit strain (LAScd) as the most powerful parameters for predicting of CA outcome with an area under the curve of 0.896 and 0.860, respectively, in the whole study group, and 0.922 and 0.938, respectively, in patients with not enlarged LA. In patients with paroxysmal AF and normal standard echocardiographic assessment, parameters reflecting LA compliance - reservoir and conduit strain, are independent and strong predictors of CA outcome. |
format | Online Article Text |
id | pubmed-8462594 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-84625942021-09-27 Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation Pilichowska-Paszkiet, Ewa Baran, Jakub Kułakowski, Piotr Zaborska, Beata Medicine (Baltimore) 3400 Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of various LA function parameters. We aimed to assess the value of detailed evaluations of LA function using STE in patients with non-valvular AF without structural heart disease to predict the outcomes after CA for AF. Secondary aim was to analyze the prediction of CA efficacy in patients with normal LA dimension in baseline echocardiography. We studied with transthoracic and transesophageal echocardiography 82 patients (58% males, mean age 57.3 ± 9.5 years) with non-valvular paroxysmal AF without structural heart disease scheduled for CA. Peak longitudinal LA strain (LAS) and strain rate (LASR) during the reservoir (r), conduit (cd) and contraction (ct) phases were measured by STE before the procedure. Patients were followed for 1 year using serial 4 to 7 day Holter ECG monitoring. Complete freedom from any AF recurrence was achieved in 44 (54%) patients. All patients had normal left ventricular systolic and diastolic function and 53 (65%) of them had not enlarged LA. In the multivariable logistic regression analysis, global left atrial reservoir strain (LASr) was identified as an independent predictor of CA efficacy (OR [95% CI]: 1.35 [1.17–1.55], P < .0001). The opportunity of CA success was 135 fold higher for each 1% increase in global LASr. The receiver operating characteristic (ROC) analysis identified global LASr and left atrial conduit strain (LAScd) as the most powerful parameters for predicting of CA outcome with an area under the curve of 0.896 and 0.860, respectively, in the whole study group, and 0.922 and 0.938, respectively, in patients with not enlarged LA. In patients with paroxysmal AF and normal standard echocardiographic assessment, parameters reflecting LA compliance - reservoir and conduit strain, are independent and strong predictors of CA outcome. Lippincott Williams & Wilkins 2021-09-24 /pmc/articles/PMC8462594/ /pubmed/34559133 http://dx.doi.org/10.1097/MD.0000000000027278 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 3400 Pilichowska-Paszkiet, Ewa Baran, Jakub Kułakowski, Piotr Zaborska, Beata Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title | Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title_full | Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title_fullStr | Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title_full_unstemmed | Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title_short | Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
title_sort | echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462594/ https://www.ncbi.nlm.nih.gov/pubmed/34559133 http://dx.doi.org/10.1097/MD.0000000000027278 |
work_keys_str_mv | AT pilichowskapaszkietewa echocardiographicassessmentofleftatrialfunctionforpredictionofefficacyofcatheterablationforatrialfibrillation AT baranjakub echocardiographicassessmentofleftatrialfunctionforpredictionofefficacyofcatheterablationforatrialfibrillation AT kułakowskipiotr echocardiographicassessmentofleftatrialfunctionforpredictionofefficacyofcatheterablationforatrialfibrillation AT zaborskabeata echocardiographicassessmentofleftatrialfunctionforpredictionofefficacyofcatheterablationforatrialfibrillation |