Echocardiographic predictors of atrial fibrillation recurrence after catheter ablation: A literature review

Liżewska-Springer, Aleksandra; Dąbrowska−Kugacka, Alicja; Lewicka, Ewa; Drelich, Łukasz; Królak, Tomasz; Raczak, Grzegorz

doi:10.5603/cj.a2018.0067

Cited by 42 publications

(32 citation statements)

References 47 publications

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“…In line with previous results (29), LVEDD was higher in the recurrence group compared to the non-recurrence one, which reflects diastolic dysfunction and impaired LVEF, both observed in AF recurrence. Averaged decreased TAPSE as well as impaired right ventricular function could be found more commonly in the recurrence group.…”

Section: Discussionsupporting

confidence: 92%

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Recurrence of Atrial Fibrillation in Dependence of Left Atrial Volume Index

Kranert

Shchetynska-Marinova

Liebe

et al. 2020

In Vivo

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Background/Aim: Despite advances in the treatment strategies of patients with atrial fibrillation (AF), the risk of AF recurrences is still over 50%. An increased left atrial volume index (LAVI) reflects left ventricular diastolic dysfunction (DD) and deterioration of the LA function. This study aims to determine AF recurrence following cardioversion (CV) or catheter ablation for AF (pulmonary vein isolation; PVI) in dependence of DD and LAVI. Patients and Methods: One hundred and sixty-two patients with paroxysmal or persistent AF in whom either CV or PVI were performed were included and followed over a mean of 22.9±3.8 months.Recurrence was defined as any recurrence of AF that occurred 3 months following the procedure. DD and LAVI were assessed using transthoracic echocardiography (TTE). Results: Recurrent AF occurred in 100 (61.7%) patients, predominantly following CV [CV 41 (76.2%) vs. PVI 59 (54.6%), p<0.0001]. Both DD and an increased LAVI were more common in the recurrence-group [DD 46.0% vs. 14.5%, p=0.0001; LAVI (ml/m 2 ) 49.0±18.6 vs. 26.3±7.0, p<0.0001]. ROC analysis revealed LAVI>36 ml/m 2 as AUC=0.92, sensitivity=76%, specificity=94%). In the multivariate analysis, DD (HR=1.6, p=0.04) and LA enlargement (defined as LAVI>36 ml/m 2 with HR=2. 1, p<0.0001) could be identified as independent predictors of AF recurrence after attempting to control the heart rhythm. Conclusion: LA enlargement and DD are independent risk factors associated with AF recurrence after initial successful rhythm control attempt. These findings have implications for timing of either ablation or CV.

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Section: Discussionsupporting

confidence: 92%

“…Assessing diastolic function has revealed significantly impaired diastolic function in the recurrence group, giving another pathophysiological hint for LA enlargement and AF recurrence (29).…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Atrial Fibrillation in Dependence of Left Atrial Volume Index

Kranert

Shchetynska-Marinova

Liebe

et al. 2020

In Vivo

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“…19 A few echocardiographic parameters have been evaluated as predictors of AF recurrence. In a literature review by Lizewska-Springer et al, 21 full-text articles were analysed and a few features were outlined. 20 Left atrial diameter, right atrial size, right atrial volume index, left ventricle ejection fraction, and diastolic dysfunction carried significant preprocedural prognostic value and outlined the following cut-off values as predictors of AF recurrence after CA:LA diameter >50-55 mm or left atrial volume indexed to body surface area >34 ml/m 2 , E/é >13-15, LA strain assessed by speckle-tracking electrocardiography <20-25% and total atrial conduction time measured by tissue Doppler imaging >150 ms.…”

Section: Predictors Of Recurrencementioning

confidence: 99%

“…A systematic review by Balk et al on the predictors of AF recurrence after radiofrequency CA synthesises the data reported in 2,169 different citations, focusing their attention on the significant preprocedural patient characteristics, such as AF type, AF duration, left atrial diameter, left ventricular ejection fraction, sex, age, the presence of structural heart disease and the presence of hypertension. 21 Their meta-analysis showed that not one of these clinical parameters is able to predict arrhythmia recurrences at a high level of evidence.…”

Section: Predictors Of Recurrencementioning

confidence: 99%

Predictors of Recurrence of AF in Patients After Radiofrequency Ablation

et al. 2019

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Catheter ablation is a well-known treatment for patients with AF. Despite the growing knowledge in the field, the identification of predictors of recurrence of AF after catheter ablation is one of the primary goals and is of major importance to improve long-term results of the procedure. The aim of this article is to provide an overview of what has been published in recent years and to summarise the major predictors, helping cardiac electrophysiologists in the selection of the right candidates for catheter ablation.

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“…The precise underlying pathophysiology of LA remodelling is also not entirely clear but include local and systemic inflammation, atrial fibrosis, atrial enlargement, altered autonomic tone, and anatomical and electrical changes [17,18]. Such structural changes and fibrosis increase the surface for multiple wave propagation, causing AF both to emerge and become more persistent [19].…”

Section: Atrial Size and Volumementioning

confidence: 99%

Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation

Gumprecht

Szulik

Domek

et al. 2019

Curr Cardiovasc Imaging Rep

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Purpose of Review Atrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on "novel" echocardiographic parameters that may be of value in the management of AF patients. Recent Findings Novel echocardiographic biomarkers and their clinical application related to the management of AF have been taken into consideration. Both standard parameters such as atrial size and volume but also novels like atrial strain and tissue Doppler techniques have been analyzed. Summary A number of novel echocardiographic parameters have been proven to enable early detection of left atrial dysfunction along with increased diagnosis accuracy. This concerns particularly experienced echocardiographers. Hence, these techniques might improve the prediction of stroke and thromboembolic events among AF patients and need to be further developed and disseminated. Nonetheless, even the standard imaging parameters could be of significant value and should not be discontinued in everyday clinical practice.

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Echocardiographic predictors of atrial fibrillation recurrence after catheter ablation: A literature review

Abstract: Background: Catheter ablation (CA) is a well-known treatment option for patients with symptomatic

Cited by 42 publications

References 47 publications

Recurrence of Atrial Fibrillation in Dependence of Left Atrial Volume Index

Recurrence of Atrial Fibrillation in Dependence of Left Atrial Volume Index

Predictors of Recurrence of AF in Patients After Radiofrequency Ablation

Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation

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