Mitral Annular Plane Systolic Excursion (MAPSE) as a Predictor of Atrial Fibrillation Recurrence in Patients after Pulmonary Vein Isolation

Abstract

Introduction. Catheter ablation (CA) with pulmonary vein isolation (PVI) has become widely used in the past years for the treatment of atrial fibrillation (AF). Mitral annular plane systolic excursion (MAPSE) is the parameter that measures left ventricular longitudinal function, and it appears to be a good early marker of LV dysfunction. It is practically independent of poor image quality. The aim of our study was to analyse the role of echocardiographic variables, especially MAPSE in predicting the outcome of CA in patients with AF. Materials and Methods. We prospectively included 40 patients with paroxysmal and persistent AF that were referred for CA. All patients underwent radiofrequency CA with PVI. Standard transthoracic two-dimensional echocardiography was conducted one day after CA. Demographic data and the patients’ characteristics were noted. The endpoint of our study was to estimate the AF recurrence rate diagnosed by ECG within 6 months of the follow-up period. Results. 40 patients, mainly male (67.5%) with an average age of 61.43 ± 8.96 years were included in our study. The majority of patients had paroxysmal AF prior to ablation (77.5%). The AF recurrence rate was 20% after 6 months of follow-up. Lateral MAPSE in the AF-free group was greater than those who relapsed (1.57 ± 0.24 vs. 1.31 ± 0.25; p = 0.012 ). Patients who remained AF-free after a 6-month follow-up period had a significantly smaller left ventricular volume index (LAVI) than those who relapsed (34.29 ± 6.91 ml/m2 vs. 42.90 ± 8.43 ml/m2; p = 0.05 ). We found a significant reverse relationship between LAVI and MAPSE ( p = 0.020 ). Conclusion. MAPSE and LAVI present risk factors for AF recurrence, specifically reduced MAPSE and larger LAVI, are related to AF recurrence after CA. In the future, MAPSE could play a significant role when predicting the CA outcome in patients with AF.

Evaluation of the Relationship Between Diabetic Retinopathy and the Development of Left Atrial Stiffness in Patients with Diabetes Mellitus

“…Furthermore, it holds prognostic significance in conditions such as atrial fibrillation, heart failure, and post-myocardial infarction cases. 26 A recent study has also pinpointed MAPSE as a noteworthy predictor for LA stiffness. 27 The augmentation of IVS thickness has long been acknowledged as a characteristic feature, particularly indicative of diastolic dysfunction in the heart.…”

Mitral annular plane systolic excursion (MAPSE) as a predictor of atrial fibrillation development after coronary artery bypass surgery

“…The relationship between LV dysfunction and the development of AF has been previously shown in the literature (28). In patients with atrial fibrillation receiving catheter ablation (CA), lower mitral annular plane systolic excursion (MAPSE) and greater left atrial volume index (LAVI) are risk factors for AF recurrence after CA determined by Alatic et al (11). In the light of all this information, we investigated the usefulness of MAPSE in predicting postoperative AF in our study.…”

“…In addition, MAPSE has been shown to be a potent prognostic factor in AF, heart failure, and post-myocardial infarction (7)(8)(9)(10). MAPSE was found to be a predictor of AF recurrence after pulmonary vein isolation by Alatic et al (11). Borde et al investigated the efficacy of MAPSE in predicting left ventricular diastolic dysfunction after off-pump CABG (12).…”