• Risako Yasuda, Mitsushige Murata, Rachel Roberts, Hanako Tokuda, Yugo Minakata, Keiko Suzuki, Hikaru Tsuruta, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoshiyasu Aizawa, Kojiro Tanimoto, Seiji Takatsuki, Takayuki Abe, and Keiichi Fukuda.
• Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
• Eur Heart J Cardiovasc Imaging. 2015 Sep 1; 16 (9): 1008-14.

AimsAccumulating data show the efficacy of catheter ablation (CA) for atrial fibrillation (AF); however, postoperative recurrence is not uncommon. The aim of this study was to identify predictors of AF recurrence in patients undergoing CA.Methods And ResultsWe studied 100 patients with symptomatic paroxysmal (68) or persistent (32) AF who underwent CA preceded by transthoracic echocardiographic examination. Of these, 50 had sinus rhythm during echocardiography (Group NSR) and 50 had AF rhythm (Group AF). The left atrial (LA) strain was measured by two-dimensional speckle tracking echocardiography. Echocardiographic parameters were compared between the patients with AF recurrence and no recurrence. During 12 months of follow-up, 26 of 100 patients (11 in Group NSR and 15 in Group AF) had AF recurrence; these patients had significantly longer AF duration, a lower LA global strain (LA-GS), lower LA lateral total strain (LA-LS), and larger maximum LA volume index (LAVImax) than those who maintained sinus rhythm. Multivariate logistic regression identified basal LA-LS and LAVImax as independent predictors of AF recurrence. Furthermore, receiver operating characteristic analyses revealed that basal LA-LS was the most useful parameter for predicting AF recurrence [area under the curve (AUC): 0.84 vs. 0.74 in LAVImax]. Subanalyses showed that LAVImax was another independent predictor of AF recurrence in Group AF, but not in Group NSR, while basal LA-LS was a significant predictor in both groups.ConclusionLA myocardial function assessed by basal LA-LS could predict AF recurrence after CA. Notably, such an assessment could be applicable even during AF rhythm, suggesting its convenience in the clinical setting without defibrillation before analysis.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

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