AF Recurrence Predictor Identified

Intra-atrial dyssynchrony during sinus rhythm independently predicts recurrence following the first catheter ablation of atrial fibrillation (AF), according to a new study.

For their study, the researchers assessed 208 patients with a history of AF (mean age 59.4 years) referred for catheter ablation of AF who had undergone pre-ablation cardiac magnetic resonance in sinus rhythm. Follow-up lasted a mean of 20 months.
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Intra-atrial dissynchrony was defined as the standard deviation of the time to the peak longitudinal strain (SD-TPS) corrected by the cycle length. The left atrial (LA) longitudinal strain each of 12 equal-length segments in 2- and 4-chamber views were measured via tissue tracking cardiac magnetic resonance.

A total of 101 patients had AF recurrence following ablation. Results indicated that SD-TPS was significantly higher in these patients vs those without recurrence (n = 107; 3.3% vs 2.2%).

Following adjustment, results of multivariable Cox analysis indicated that SD-TPS was associated with recurrence. The researchers also found via receiver-operator characteristics analysis that prediction of recurrence was improved with SD-TPS compared with clinical risk factors, LA structure and function, and fibrosis.

“Intra-atrial dyssynchrony during sinus rhythm is an independent predictor of recurrence after the first catheter ablation of paroxysmal or persistent AF,” the researchers concluded. “Assessment of intra-atrial dyssynchrony may improve ablation outcomes by refining patient selection.”

—Christina Vogt

Reference:

Ciuffo L, Tao S, Ipek EG, et al. Intra-atrial dyssynchrony during sinus rhythm predicts recurrence after the first catheter ablation for atrial fibrillation [Published online January 2018]. JACC Cardiovasc Imaging. doi:10.1016/j.jcmg.2017.11.028.