Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation

<h4>Objective</h4> Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a...

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Autores principales: Andreea Motoc, Maria–Luiza Luchian, Esther Scheirlynck, Bram Roosens, Hadischat Chameleva, Maxim Gevers, Xavier Galloo, Berlinde von Kemp, Robbert Ramak, Juan Sieira, Carlo de Asmundis, Gian–Battista Chierchia, Julien Magne, Caroline Weytjens, Steven Droogmans, Bernard Cosyns
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:a1e5d63148334b0bbc89ad2d0d1d036f2021-11-25T06:19:27ZIncremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation1932-6203https://doaj.org/article/a1e5d63148334b0bbc89ad2d0d1d036f2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604362/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4> Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear before the enlargement of the LA. The purpose of this study was to evaluate the additional predictive value of LA function assessed using strain echocardiography for AF recurrence after CBA. <h4>Methods</h4> 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively analyzed. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period. <h4>Results</h4> 50 (29%) patients had AF recurrence. In the overall study population, peak atrial longitudinal strain (PALS) ≤ 17% had the highest incremental predictive value for AF recurrence (HR = 9.45, 95%CI: 3.17–28.13, p < 0.001). In patients with non-dilated LA, PALS≤17% remained an independent predictor of AF recurrence (HR = 5.39, 95%CI: 1.66–17.52, p = 0.005). <h4>Conclusions</h4> This study showed that LA function assessed by PALS provided an additional predictive value for AF recurrence after CBA, over LA enlargement. In patients with non—dilated LA, PALS also predicted AF recurrence. These findings emphasize the added value of LA strain, suggesting that it should be implemented in the systematic evaluation of AF patients before CBA.Andreea MotocMaria–Luiza LuchianEsther ScheirlynckBram RoosensHadischat ChamelevaMaxim GeversXavier GallooBerlinde von KempRobbert RamakJuan SieiraCarlo de AsmundisGian–Battista ChierchiaJulien MagneCaroline WeytjensSteven DroogmansBernard CosynsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Andreea Motoc
Maria–Luiza Luchian
Esther Scheirlynck
Bram Roosens
Hadischat Chameleva
Maxim Gevers
Xavier Galloo
Berlinde von Kemp
Robbert Ramak
Juan Sieira
Carlo de Asmundis
Gian–Battista Chierchia
Julien Magne
Caroline Weytjens
Steven Droogmans
Bernard Cosyns
Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
description <h4>Objective</h4> Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear before the enlargement of the LA. The purpose of this study was to evaluate the additional predictive value of LA function assessed using strain echocardiography for AF recurrence after CBA. <h4>Methods</h4> 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively analyzed. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period. <h4>Results</h4> 50 (29%) patients had AF recurrence. In the overall study population, peak atrial longitudinal strain (PALS) ≤ 17% had the highest incremental predictive value for AF recurrence (HR = 9.45, 95%CI: 3.17–28.13, p < 0.001). In patients with non-dilated LA, PALS≤17% remained an independent predictor of AF recurrence (HR = 5.39, 95%CI: 1.66–17.52, p = 0.005). <h4>Conclusions</h4> This study showed that LA function assessed by PALS provided an additional predictive value for AF recurrence after CBA, over LA enlargement. In patients with non—dilated LA, PALS also predicted AF recurrence. These findings emphasize the added value of LA strain, suggesting that it should be implemented in the systematic evaluation of AF patients before CBA.
format article
author Andreea Motoc
Maria–Luiza Luchian
Esther Scheirlynck
Bram Roosens
Hadischat Chameleva
Maxim Gevers
Xavier Galloo
Berlinde von Kemp
Robbert Ramak
Juan Sieira
Carlo de Asmundis
Gian–Battista Chierchia
Julien Magne
Caroline Weytjens
Steven Droogmans
Bernard Cosyns
author_facet Andreea Motoc
Maria–Luiza Luchian
Esther Scheirlynck
Bram Roosens
Hadischat Chameleva
Maxim Gevers
Xavier Galloo
Berlinde von Kemp
Robbert Ramak
Juan Sieira
Carlo de Asmundis
Gian–Battista Chierchia
Julien Magne
Caroline Weytjens
Steven Droogmans
Bernard Cosyns
author_sort Andreea Motoc
title Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
title_short Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
title_full Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
title_fullStr Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
title_full_unstemmed Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
title_sort incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/a1e5d63148334b0bbc89ad2d0d1d036f
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