Abstract 12359: Does E/e’ Independently Predict Atrial Fibrillation Recurrence Post Catheter Ablation?

Abstract

Introduction: Left atrial size has been traditionally used as a surrogate of atrial fibrillation (AF) chronicity and prognosticator for success post catheter ablation (CA). The importance of other echocardiographic parameters in predicting maintenance of sinus rhythm post CA has not been well studied. Research Question: Which echocardiographic parameter best predicts 1 year AF-free survival post CA? Goal: Elucidate which parameter best independently predicts AF recurrence and identify which patients may benefit from earlier intervention. Methods: We conducted a retrospective cohort study of patients with symptomatic AF. We included patients who were undergoing first-time ablation and had follow-up visits for at least 24 months post CA. Baseline echocardiographic and laboratory data were extracted from common electronic medical records across a large healthcare system. Clinical outcomes were determined after manual review of each 6, 12, and 24-month visit. Echocardiographic measures were used in a stepwise estimation logistic regression model using STATA /IC 16.1. Results: Out of a cohort of 1,435 patients (age 67.1 ± 10.4 years, 565 female) who received CA for AF between 2014 and 2022, 402 had AF recurrence at their 12-month follow-up visit (28%). Larger left atrial volumes (p = 0.01), higher mitral valve E/e’ ratios (p = 0.008), and higher degree of aortic regurgitation (p = 0.02) were univariately associated with AF recurrence in 1 year. Stepwise estimation regression model showed that after adjusting for age, sex, BMI, mitral valve E/e’, and left atrial volume, the only independently associated predictor was mitral valve E/e’. The R 2 of our model was 0.31 and its predictive accuracy for recurrence was 85%. Conclusion: Among all echocardiographic measures, the diastolic dysfunction parameter of E/e’ was the only independent predictor of 1-year AF recurrence.