Evaluating of left atrial remodeling and predicting the efficacy of radiofrequency catheter ablation with atrial fibrillation by speckle tracking imaging

Abstract

Objective To evaluate left atrial function dynamic changes before and after radiofrequency catheter ablation (CA) with persistent atrial fibrillation (AF) and predict the maintain sinus rhythm of postoperative atrial fibrillation by speckle tracking imaging. Methods The study was including 45 cases underwent CA with persistent AF(preoperative 1 week, postoperative 24 hours, 3 months, 6 months) and 25 normal cases. Left atrial function and strain rate were analysed. These index were measured and calculated: the left atrial diameter index(LADI), left atrial area index(LAAI), left atrial maximum volume index(LAVImax) and left atrial ejection fraction(LAEF), left atrial wall strain rate of left ventricular systolie (SRs), left atrial wall strain rate of left ventricular early diastolie (SRe), left atrial systolic strain rate(SRa) and the average of left atrial wall each phase strain rate. Results ①LADI, LAAI, LAVImax were significantly increased; LAEF, SRs, SRe were decreased significantly; SRa were disappeared with AF compared with the control group. ②LADI, LAAI, LAVImax decreased gradually, LAEF, SRs, SRe, SRa were gradually increased with the extension of the follow-up time. ③Left atrial average SRs predicted maintenance of sinus rhythm with atrial fibrillation after operation of CA(odds ratio=0.607, 95% CI=0.417-0.819, correction of P=0.017) was an independent predictor. Conclusions Speckle tracking imaging can quantitative evaluate left atrial function with persistent AF after CA. Left atrial global reservoir function predicts the efficacy of CA. Key words: Echocardiography; Atrial fibrillation; Atrial function, left; Speckle tracking imaging