Left Atrial Function Predicts Success Of Percutaneous Atrial Fibrillation Ablation

Background:While the radiofrequency catheter ablation(RFCA) is widely used in the treatment of atrial fibrillation, a lot of researches focus on the predictors of atrial fibrillation recur after RFCA. Objective:The purpose of this study was to evaluate Left atrial function as potential predictors of recurrence after radiofrequency catheter ablation for atrial fibrillation. Method:From January April 2015 to 2016, 26 patients with paroxysmal atrial fibrillation who underwent radiofrequency catheter ablation by the same operation were enrolled in the study(experimental group, n=26), Twenty-six age- and gender-matchedhealthy volunteers(control group, n=26) were included. Echocardiography was performed in all patients in sinus rhythm before RFCA, 48 hours after RFCA and 3 months after RFCA and in all volunteers. LA function were measured using Radial Strain(RS), Circumferential Strain(CS),Longitudinal Strain(LS), Peak time standard deviation(PTSD) representatives left atrium movement synchronicity and Left atrial ejection fraction(LAEF) with three-dimensional speckle trackingechocardiography(3DSTE). The effectiveness of RFCA on arrhythmia recurrence was evaluated at 3-month follow-up. The standard for the recurrence of AF after RFCA was that atrial fibrillation、atrial tachycardia or atrial flutter came out and sustained over 30 s more than 3 months following RFCA. Result:In AF group compared to control group, left atrial diameter, LSPTSD was significantly lower in control group patients compared to the atrial fibrillation group, and the difference is statistically significant(29.85±3.91 mm vs 37.27±5.88 mm, P=0.000; 94.36±45.77 ms vs 165.82±71.61 ms, P=0.000); LS, LAEF was significantly higher in control group patients compared to the atrial fibrillation group, and the difference is statistically significant(25.55±5.56% vs 13.88 ± 8.39%, P=0.000; 49.61 ± 8.15% vs 38.69 ± 12.31%, P=0.000). Patients were evaluated at 3-month follow-up after RFCA, 12 cases recurrence, 14 cases no recurrence, the overall recurrence rate was 46.15%. Gender, age, diabetes mellitus, hypertension, hyperlipidemia, coronary heart disease, left ventricular ejection fraction, left atrial diameter and postoperative medication were not significantly different in the two groups(P>0.05). LS, LAEF was significantly lower in Recurrence group patients compared to the non recurrence group, and the difference was statistically significant(8.23±18.72 VS 7.42% ± 5.85%, P=0.000; 31.99 ± 13.2% VS 8.20% ± 44.42, P=0.007); Logistic regression analysis suggested LS was the independent predictors of recurrence of atrial fibrillation after radiofrequency catheter ablation. Compared the left atrial function with the preoperative, postoperative and 3 months after RFCA, LSPTSD was significantly lower in group 3 months after RFCA patients compared to preoperative group, and the difference was statistically significant(128.68±32.22 ms VS 165.82±71.61 ms, P<0.005). Conclusion:LS, LSPTSD, LAEF can be used as an index to evaluate the atrial function. Left atrial function is a reliable toolfor predicting success after RFCA, it could improve candidate selection for RFCA.RFCA can improve left atrial function in patients with atrial fibrillation.