Left atrial strain predicts atrial tachyarrhythmia recurrence after catheter ablation

In patients who had received catheter ablation (CA) for atrial fibrillation (AF), left atrial (LA) deformation analysis can help assess the risk of atrial tachyarrhythmia (ATA) recurrence, reports a new study.

The study included 678 AF patients (median age 63.2 years, 72 percent men) who had undergone two-dimensional speckle tracking echocardiography (2DSTE) before CA. LA deformation parameters included LA strain during reservoir (LASr), contraction (LASct), and conduit (LAScd) phases.

Over the 1-year follow-up period, 274 patients experienced the primary outcome of ATA recurrence, corresponding to a 40-percent rate. LASr (22.6 percent vs 25.1 percent; p=0.001) and LASct (10.7 percent vs 12.4 percent; p<0.001) were both significantly lower in those with ATA recurrence, while no such difference was reported for LAScd.

Multivariable-adjusted logistic regression analysis confirmed that lower LASr was a significant correlate of ATA recurrence, such that each 1-percent decrease increased the outcome likelihood by 4 percent (odds ratio [OR] per 1-percent decrease, 1.04, 95 percent confidence interval [CI], 1.01–1.07; p=0.015). A similar effect was reported for LASct (OR per 1-percent decrease, 1.06, 95 percent CI, 1.02–1.11; p=0.007).

Of note, even in patients with normal-sized LAs, LASct remained a significant predictor of ATA recurrence (OR per 1-percent decrease, 1.07, 95 percent CI, 1.01–1.12; p=0.012).

“Our study suggests that assessment of LA function, particularly LASct, using 2DSTE could be of use in clinical practice in risk stratification,” the researchers said. “Including LASct and LASr in the clinical assessment prior to CA could lead to earlier CA treatment in high-risk patients as well as a closer follow-up.”