Value of dual Doppler echocardiography for prediction of atrial fibrillation recurrence after radiofrequency catheter ablation

Abstract

BackgroundIncreasing evidence has been presented which suggests that left ventricular (LV) diastolic dysfunction may play an important role in the development of atrial fibrillation (AF). However, the potential for LV diastolic dysfunction to serve as a predictor of AF recurrence after radiofrequency catheter ablation remains unresolved.MethodsDual Doppler and M-PW mode echocardiography were performed in 67 patients with AF before ablation and 47 patients with sinus rhythm. The parameters measured within identical cardiac cycles included, the time interval between the onset of early transmitral flow peak velocity (E) and that of early diastolic mitral annular velocity (e’) (TE-e’), the ratio of E to color M-mode Doppler flow propagation velocity (Vp)(E/Vp), the Tei index, the ratio of E and mitral annular septal (S) peak velocity in early diastolic E/e’(S) and the ratio of E and mitral annular lateral (L) peak velocity E/e’(L). A follow-up examination was performed 1 year after ablation and patients were divided into two groups based on the presence or absence of AF recurrence. Risk estimations for AF recurrence were performed using univariate and multivariate logistic regression.ResultsTE-e’, E/Vp, the Tei index, E/e’(S) and E/e’(L) were all increased in AF patients as compared with the control group (p < 0.05). At the one-year follow-up examination, a recurrence of AF was observed in 21/67 (31.34%) patients. TE-e’ and the Tei index within the recurrence group were significantly increased as compared to the group without recurrence (p < 0.001). Results from multivariate analysis revealed that TE-e’ can provide an independent predictor for AF recurrence (p = 0.001).ConclusionsDual Doppler echocardiography can provide an effective and accurate technique for evaluating LV diastolic function within AF patients. The TE-e’ obtained within identical cardiac cycles can serve as an independent predictor for the recurrence of AF as determined at 1 year after ablation.

The Role of Cardiac Structural Remodeling Under Atrial Fibrillation: Imaging Basics for Predicting Recurrence (Literature Review)

“…Поява рецидиву аритмії після катетерної абляції залежить від різних факторів, таких як діаметр лівого передсердя (ДЛП) або об'єм ЛП (ОЛП), фракція викиду (ФВ) лівого шлуночка (ЛШ) і рубцювання ЛП. [9] Попереднє структурне ремоделювання ЛП є сильним та незалежним предиктором рецидиву ФП після катетерної абляції, тому що структурні зміни міокарду ЛП були ідентифіковані як аритмогенний субстрат рецидиву аритмії [13].…”

Value of Imaging in the Non-Invasive Prediction of Recurrence after Catheter Ablation in Patients with Atrial Fibrillation: An Up-to-Date Review

“…Studies have reported a significantly higher LA volume index in patients with AF relapse, attributing to the association between AF recurrence and poor LA structural remodeling [ 22 , 23 , 24 ]. A growing series of studies also claim an independent relationship between functional indices, such as left ventricular (LV) and LA ejection fraction, and the ratio of mitral inflow velocity to mitral annular tissue velocity (E/e’) and AF recurrence after CA [ 16 , 19 , 25 , 26 ]. Of these patients, lower LV and LA ejection fractions and higher E/e’ signify higher AF recurrence, probably because AF not only promotes the structural remodeling of LA but also leads to its functional alteration [ 16 , 19 , 25 , 26 ].…”

“…A growing series of studies also claim an independent relationship between functional indices, such as left ventricular (LV) and LA ejection fraction, and the ratio of mitral inflow velocity to mitral annular tissue velocity (E/e’) and AF recurrence after CA [ 16 , 19 , 25 , 26 ]. Of these patients, lower LV and LA ejection fractions and higher E/e’ signify higher AF recurrence, probably because AF not only promotes the structural remodeling of LA but also leads to its functional alteration [ 16 , 19 , 25 , 26 ]. As such, a low functional index, as assessed using ultrasound, predicts a high rate of postoperative AF recurrence.…”

Incremental predictive utility of a radiomics signature in a nomogram for the recurrence of atrial fibrillation

“…Previous studies on AF have indicated that it may lead to structural and functional remodeling of the left atrium (LA) (9). Consequently, there is interest in predicting the likelihood of recurrence by an accurate evaluation of the abnormalities of LA structure and function, which may aid in patient selection and post-CA planning (10)(11)(12).…”