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Left atrial strain as predictor of successful outcomes in catheter ablation for atrial fibrillation: a two-dimensional myocardial imaging study

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Abstract

Background

The objective of this study was to investigate atrial myocardial properties through two-dimensional (2D) myocardial imaging in patients with atrial fibrillation (AF) and its predictive role for recurrence after catheter ablation.

Methods and results

Echocardiographic examinations were performed in 40 patients with paroxysmal AF before catheter ablation and 40 age- and gender-matched healthy control subjects. Using a software package, bidimensional acquisitions were analyzed to measure longitudinal strain and strain rate for the left atrium (LA). Systolic strain and strain rate in all eight segments, and its average values, were significantly reduced in AF patients compared to controls. During 9 months of follow-up after catheter ablation for AF, 11 of 40 AF patients had AF recurrence. AF recurrence was associated with gender, LA volume index, and average values of systolic strain and strain rate. By multivariate analysis, only average strain was an independent predictor of AF recurrence (OR = 0.88, 95% CI 0.79-0.98, p = 0.018).

Conclusions

Lower systolic strain of LA was strongly associated with recurrence after catheter ablation. Thus, diverse adjunctive ablation strategies should be considered to reduce recurrence in patients with lower systolic strain.

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Authors and Affiliations

  1. Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Shinchon-dong 134, Seodaemun-gu, Seoul, South Korea, 120-752

    Hye Jin Hwang, Eui-Young Choi, Sang Jae Rhee, Boyoung Joung, Byung-Ho Lee, Sang-Hee Lee, Jaedeok Kim, Moon-Hyoung Lee, Yangsoo Jang, Namsik Chung & Sung Soon Kim

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  1. Hye Jin Hwang
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  2. Eui-Young Choi
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  3. Sang Jae Rhee
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  4. Boyoung Joung
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  5. Byung-Ho Lee
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  6. Sang-Hee Lee
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  7. Jaedeok Kim
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  8. Moon-Hyoung Lee
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  9. Yangsoo Jang
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  10. Namsik Chung
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  11. Sung Soon Kim
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Correspondence to Moon-Hyoung Lee.

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Hwang, H.J., Choi, EY., Rhee, S.J. et al. Left atrial strain as predictor of successful outcomes in catheter ablation for atrial fibrillation: a two-dimensional myocardial imaging study. J Interv Card Electrophysiol 26, 127–132 (2009). https://doi.org/10.1007/s10840-009-9410-y

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  • DOI: https://doi.org/10.1007/s10840-009-9410-y

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