Risk factors for atrial fibrillation recurrence

Abstract

Atrial fibrillation is the most common arrhythmia managed in clinical practice and it is associated with an increased risk of mortality, stroke and peripheral embolism. Unfortunately, the incidence of atrial fibrillation recurrence ranges from 40 to 50%, despite the attempts of electrical cardioversion and the administration of antiarrhythmic drugs. In this review, the literature data about predictors of atrial fibrillation recurrence are highlighted, with special regard to clinical, therapeutic, biochemical, ECG and echocardiographic parameters after electrical cardioversion and ablation. Identifying predictors of success in maintaining sinus rhythm after cardioversion or ablation may allow a better selection of patients to undergo these procedures. The aim is to reduce healthcare costs and avoid exposing patients to unnecessary procedures and related complications. Recurrent atrial fibrillation depends on a combination of several parameters and each patient should be individually assessed for such a risk of recurrence.

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

“…The success rate of CA, defined as no AF relapse, of up to 70% for patients with paroxysmal AF and around 50% in those with persistent AF [1]. Multiple factors have been identified for AF recurrence after CA, such as age, AF duration, ventricular and atrial function and comorbidities, however their predictive value is rather small [1,2]. Therefore, new predictors of procedural outcome are needed for better identification of the most suitable candidates for CA.…”

Increased left atrial size is associated with higher atrial fibrillation recurrence in patients treated with antiarrhythmic medications

“…Our present study is to date the largest real‐world data evaluating echocardiographic predictors of AF recurrence among patients treated with antiarrhythmic agents. Several other studies have evaluated echocardiographic predictors for AF recurrence in patients treated with cardioversion and ablation, but these were limited by relatively small populations . The randomized controlled Atrial Fibrillation Follow‐up Investigation of Rhythm Management (AFFIRM) trial also evaluated AF recurrence among patients treated with antiarrhythmic medications .…”

Left atrial mechanical remodelling assessed as the velocity of left atrium appendage wall motion during atrial fibrillation is associated with maintenance of sinus rhythm after electrical cardioversion in patients with persistent atrial fibrillation

“…[4] Different groups have reported on potential clinical, imaging, and laboratory predictors of sinus rhythm maintenance after cardioversion of AF. [5][6][7][8] To assess the mechanical function of the left atrium (LA) or left atrial appendage (LAA) by echocardiography, we can use the assessment of the left atrial emptying fraction (LA EF), measurement of blood flow velocity through the mitral valve, strain or strian rate using tissue doppler technique imagine (TDI) or speckle tracking echocardiography (STE) and measurements of left atrial appendage emptying velocity (LAAEV). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Currently, much attention is paid to the use of STE technique to assess the mechanical function of LA and LAA, however, due to the limitations of this method, i.e.…”