Left atrial strain predicts reverse remodeling after catheter ablation for atrial fibrillation

J Am Coll Cardiol. 2011 Jan 18;57(3):324-31. doi: 10.1016/j.jacc.2010.05.063.

Abstract

Objectives: The purpose of this study was to assess left atrial (LA) strain during long-term follow-up after catheter ablation for atrial fibrillation and to find predictors for LA reverse remodeling.

Background: The association between LA reverse remodeling and improvement in LA strain after catheter ablation has not been investigated thus far.

Methods: In 148 patients undergoing catheter ablation for atrial fibrillation, LA volumes and LA strain were assessed with echocardiography at baseline and after a mean of 13.2 ± 6.7 months of follow-up. The study population was divided according to LA reverse remodeling at follow-up: responders were defined as patients who exhibited 15% or more reduction in maximum LA volume at long-term follow-up. Left atrial systolic (LAs) strain was assessed with tissue Doppler imaging.

Results: At follow-up, 93 patients (63%) were classified as responders, whereas 55 patients (37%) were nonresponders. At baseline, LAs strain was significantly higher in the responders as compared with the nonresponders (19 ± 8% vs. 14 ± 6%; p = 0.001). Among the responders, a significant increase in LAs strain was noted from baseline to follow-up (from 19 ± 8% to 22 ± 9%; p < 0.05), whereas no change was noted among the nonresponders. LAs strain at baseline was an independent predictor of LA reverse remodeling (odds ratio: 1.813; 95% confidence interval: 1.102 to 2.982; p = 0.019).

Conclusions: In the present study, 63% of the patients exhibited LA reverse remodeling after catheter ablation for atrial fibrillation, with a concomitant improvement in LA strain. LA strain at baseline was an independent predictor of LA reverse remodeling.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / surgery*
  • Atrial Function, Left / physiology*
  • Catheter Ablation* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Registries
  • Ventricular Remodeling / physiology*