Predictors of early recurrence of atrial tachyarrhythmias after catheter ablation of atrial fibrillation

Abstract

Aim. Search for predictors of early recurrence of atrial tachyarrhythmias after radiofrequency ablation (RFA) of atrial fibrillation (AF).Methods. The study included 57 subjects with persistent (n = 17; 30%) and paroxysmal (n = 40; 70%) forms of AF, admitted for the RFA. All patients underwent transthoracic echocardiography, assessment of deformation of both atria using 2D Strain, computed tomography (CT) with 3D reconstruction of the left atrium (LA). Intraoperatively, high-density voltage mapping of LA was performed before RF pulmonary vein isolation. All patients underwent follow-up after 3 months.Results. Recurrence of atrial tachyarrhythmia after 3 months was recorded in 17.5% of patients. High prevalence of low-amplitude activity zones in the LA and persistent AF were the strongest predictors. The LA reservoir function below 21.7%, the conduction function below 15.7%, the LA stiffness index above 0.314 relative units, the LA volume with the appendage above 121.7 ml, and the LA vertical size according to CT data above 65.5 mm statistically significantly predicted early recurrences of atrial tachyarrhythmias with high sensitivity and specificity.Conclusion. The decreased LA deformation in the reservoir and conductor phase, increased LA stiffness index, the prevalence of low-amplitude activity zones, vertical size and volume of the LA with an auricle according to CT data and persistent AF are significant predictors of early relapses after interventional treatment of AF.