Songnan Wen, Manasawee Indrabhinduwat, Peter A Brady, Cristina Pislaru, Fletcher A Miller, Naser M Ammash, Vuyisile T Nkomo, Ratnasari Padang, Sorin V Pislaru, Grace Lin
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The primary endpoint was atrial tachyarrhythmia recurrence after ablation.</p><p><strong>Results: </strong>A total of 144 patients were enrolled (mean age 61 ± 11 years, 77% male, 46% persistent AF). PACS and LAEF initially decreased 1-day following ablation but partially recovered within 3 months in PAF patients, with a similar trend in the PerAF patients. After median 24 months follow-up, 68 (47%) patients had recurrence. Patients with recurrence had higher PACS<sub>1-day</sub> than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS<sub>1-day</sub> -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan-Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS<sub>1-day</sub> was an independent risk factor of arrhythmia recurrence.</p><p><strong>Conclusions: </strong>Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS<sub>1-day</sub> post procedure predicts arrhythmia recurrence at long-term follow-up.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"22"},"PeriodicalIF":1.9000,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00250-5","citationCount":"7","resultStr":"{\"title\":\"Post Procedural Peak Left Atrial Contraction Strain Predicts Recurrence of Arrhythmia after Catheter Ablation of Atrial Fibrillation.\",\"authors\":\"Songnan Wen, Manasawee Indrabhinduwat, Peter A Brady, Cristina Pislaru, Fletcher A Miller, Naser M Ammash, Vuyisile T Nkomo, Ratnasari Padang, Sorin V Pislaru, Grace Lin\",\"doi\":\"10.1186/s12947-021-00250-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. 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Patients with recurrence had higher PACS<sub>1-day</sub> than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS<sub>1-day</sub> -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan-Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS<sub>1-day</sub> was an independent risk factor of arrhythmia recurrence.</p><p><strong>Conclusions: </strong>Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS<sub>1-day</sub> post procedure predicts arrhythmia recurrence at long-term follow-up.</p>\",\"PeriodicalId\":9613,\"journal\":{\"name\":\"Cardiovascular Ultrasound\",\"volume\":\"19 1\",\"pages\":\"22\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2021-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/s12947-021-00250-5\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12947-021-00250-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12947-021-00250-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 7
摘要
背景:心房颤动(AF)消融可损害左心房(LA)功能，并可能与复发风险相关。我们试图确定手术后LA功能的改变是否会影响房颤消融后复发的风险。方法:回顾性分析2009年至2011年间接受房颤消融并在消融前、消融后1天和消融后3个月行经胸超声心动图检查的患者。评估窦性心律期间左心房收缩应变峰值(PACS)和左心房排空分数(LAEF)，并比较三个时间点的差异。主要终点为消融后房性心动过速复发。结果:共纳入144例患者(平均年龄61±11岁，77%为男性，46%为持续性房颤)。PACS和LAEF在消融后1天开始下降，但PAF患者在3个月内部分恢复，PerAF患者也有类似的趋势。中位随访24个月后，68例(47%)患者复发。复发组pacs1 -d高于非复发组(-10.9±5.0% vs -13.4±4.7%，p = 0.003)。pacs1 -12%区分复发病例，敏感性67.7%，特异性60.5%。Kaplan-Meier曲线显示PACS≥-12%的患者5年累计复发概率差异显著，PACS 1天是心律失常复发的独立危险因素。结论:左心房功能在房颤消融后立即恶化，3个月后部分恢复，但多数患者仍保持异常。术后1天pacs1可预测长期随访心律失常复发。
Post Procedural Peak Left Atrial Contraction Strain Predicts Recurrence of Arrhythmia after Catheter Ablation of Atrial Fibrillation.
Background: Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. We sought to determine whether the post-procedural changes in LA function impact the risk of recurrence following AF ablation.
Methods: We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. Peak left atrial contraction strain (PACS) and left atrial emptying fraction (LAEF) were evaluated during sinus rhythm and compared across the three time points. The primary endpoint was atrial tachyarrhythmia recurrence after ablation.
Results: A total of 144 patients were enrolled (mean age 61 ± 11 years, 77% male, 46% persistent AF). PACS and LAEF initially decreased 1-day following ablation but partially recovered within 3 months in PAF patients, with a similar trend in the PerAF patients. After median 24 months follow-up, 68 (47%) patients had recurrence. Patients with recurrence had higher PACS1-day than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS1-day -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan-Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS1-day was an independent risk factor of arrhythmia recurrence.
Conclusions: Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS1-day post procedure predicts arrhythmia recurrence at long-term follow-up.
期刊介绍：
Cardiovascular Ultrasound is an online journal, publishing peer-reviewed: original research; authoritative reviews; case reports on challenging and/or unusual diagnostic aspects; and expert opinions on new techniques and technologies. We are particularly interested in articles that include relevant images or video files, which provide an additional dimension to published articles and enhance understanding.
As an open access journal, Cardiovascular Ultrasound ensures high visibility for authors in addition to providing an up-to-date and freely available resource for the community. The journal welcomes discussion, and provides a forum for publishing opinion and debate ranging from biology to engineering to clinical echocardiography, with both speed and versatility.
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