Clinical and echocardiographic predictors of recurrence of AF after one catheter ablation (CA) procedure (primary endpoint)
| Recurrence of AF after one CA procedure | ||||||
| Univariate Cox analysis | Multivariate Cox analysis | |||||
| Predictors | HR | 95% CI | p Value | HR | 95% CI | p Value |
| LA myocardial characteristics | ||||||
| LA strain <10% | 9.5 | 4.9 to 18.5 | <0.001 | 6.4 | 2.4 to 16.9 | <0.001 |
| LA strain 10–14.5% | 0.7 | 0.3 to 1.4 | 0.305 | 0.7 | 0.3 to 1.4 | 0.305 |
| LA strain >14.5% | 0.07 | 0.02 to 0.2 | <0.001 | 0.2 | 0.05 to 0.7 | <0.001 |
| LA enlargement | ||||||
| LA diameter >40 mm | 1.3 | 0.7 to 2.2 | 0.281 | 0.9 | 0.4 to 1.9 | 0.978 |
| LA area >20 cm² | 1.5 | 0.9 to 2.6 | 0.107 | 1.5 | 0.9 to 2.6 | 0.107 |
| LA volume >58 mL | 1.3 | 0.7 to 2.2 | 0.330 | 1.3 | 0.7 to 2.2 | 0.330 |
| LAVI >28 mL/m² | 1.8 | 1.0 to 3.0 | 0.033 | 1.6 | 0.5 to 5.2 | 0.376 |
| LV function and remodelling | ||||||
| LV hypertrophy | 0.9 | 0.5 to 1.6 | 0.923 | 0.8 | 0.4 to 1.5 | 0.579 |
| LV longitudinal systolic dysfunction | 2.4 | 1.0 to 5.7 | 0.036 | 0.4 | 0.1 to 1.5 | 0.214 |
| LV longitudinal diastolic dysfunction | 1.5 | 0.8 to 2.9 | 0.161 | 0.5 | 0.2 to 1.2 | 0.146 |
| Clinical characteristics | ||||||
| >75 years of age | 1.7 | 0.8 to 3.4 | 0.122 | 0.4 | 0.1 to 1.4 | 0.187 |
| Type II diabetes | 0.9 | 0.3 to 2.3 | 0.861 | 0.4 | 0.1 to 2.0 | 0.289 |
| Hypertension | 1.7 | 0.9 to 3.4 | 0.091 | 1.8 | 0.8 to 4.1 | 0.121 |
| Obesity | 0.8 | 0.4 to 1.4 | 0.499 | 0.5 | 0.2 to 1.0 | 0.087 |
| History of CAD | 1.7 | 0.9 to 3.0 | 0.059 | 2.0 | 0.9 to 4.5 | 0.076 |
| CHA2DS2-VASc score ≥2 | 2.2 | 1.2 to 4.1 | 0.011 | 0.8 | 0.3 to 2.1 | 0.802 |
| CHADS2score ≥2 | 1.0 | 0.5 to 2.0 | 0.989 | 1.5 | 0.4 to 5.6 | 0.471 |
| PVI alone | 0.9 | 0.5 to 1.6 | 0.887 | 0.9 | 0.5 to 1.6 | 0.887 |
| PVI + additional LA lesions | 1.0 | 0.6 to 1.7 | 0.887 | 0.6 | 0.3 to 1.3 | 0.250 |
Recurrence of AF during the follow-up period of 15 months. Additional LA lesions, LA linear lesions (LA roof line and mitral isthmus line) and ablation of regions with complex fractionated electrograms. LV longitudinal systolic and diastolic dysfunction was defined as LV strain > −16% and LV SRe <0.95 s−1, respectively. LV hypertrophy = LV mass ≥96 g/m2 in women or ≥116 g/m2 in men.
AF, atrial fibrillation; CAD, coronary artery disease; LAVI, LA volume index; LV, left ventricular; PVI, pulmonary vein ablation; SRe, early-diastolic strain rate.