The predictive value of atrial synchronization for recurrence after radiofrequency catheter ablation in paroxysmal atrial fibrillation patients by dual gate Dopper

Abstract

Objective To discuss whether atrial synchronization measured by dual gate Dopper can predict recurrence after radiofrequency catheter ablation (RFCA) in paroxysmal atrial fibrillation (PAF) patients. Methods Forty-five patients with PAF who had successful RFCA and 26 controls with sinus rate were prospectively enrolled. During 6-month follow-up, the patients with PAF were divided into AF recurrence group (n=16) and AF non-recurrence group (n=29). All patients with PAF underwent echocardiography in the preoperative 7 days. The time interval of the onset of the late diastolic (a′) wave between mitral annular septal and lateral site was T1 by dual gate Doppler, which was used to evaluate left atrial synchronization. The time intervals from the onset of a′ wave at tricuspid annulus right ventricular free wall site to a′ wave at tricuspid annular septal site and mitral annular lateral site were T2 and T3, which were respectively used to evaluate right atrial and interatrial synchronization. The greater time interval predicted the worse synchronization. Results Compared with controls, left atrial diameter, volume and volume index, right atrial transverse diameter, volume and volume index, T1, T2 and T3 (standardized before and after) increased in patients with PAF (all P 0.05). But there was a trend toward lager left atrial diameter in the AF recurrence group (P<0.05). T1 and T3 (standardized before and after) increased significantly in AF recurrence group (all P<0.05). Multivariate logistic regression analysis indicated standardized T1 was the only independent predicator of AF recurrence after RFCA (OR=1.060, 95% CI 1.002-1.121, P=0.044). The area under curve of standardized T1 for predicting recurrence was 0.709%, the sensitivity and specificity were 62.5% and 75.9% using a cutoff value of standardized T1≥39.38 ms. Conclusions T1 significantly prolongs in patients with AF recurrence. Dual gate Doppler as a new technique to evaluate atrial synchronization can provide predictive value for 6-month recurrence after RFCA. Key words: Echocardiography; Atrial Fibrillation; Atrial function; Dual gate Doppler