The predictive value of E/e′ for recurrence after radiofrequency catheter ablation in persistant atrial fibrillation patients by dual gate Doppler

Abstract

Objective To discuss the value of E/e′ index measured by dual gate Dopper predicting recurrence after radio frequency catheter ablation (RFCA) in persistant atrial fibrillation (PeAF) patients. Methods Fifty-three patients with PeAF who had successful RFCA and 25 controls were prospectively enrolled. The patients with PeAF were divided into AF recurrence group (n=21) and AF non-recurrence group (n=32) with median follow-up time of (25.94±2.78)months. All patients with PeAF underwent echocardiography in the preoperative 7 days. With dual gate Doppler, transmitral flow peak velocity (E) and mitral annular septal or lateral peak velocity e′(S), and e′(L) in early diastolic were measured simultaneously in the same cardiac cycle, then E/e′(S) and E/e′(L) were automatically calculated.With traditional method, E, e′(S) and e′(L) were measured in different cardiac cycles, then E/e′(S) and E/e′(L) were manually calculated.The time of whole analysis process with each method was recorded. Results PeAF patients had bigger E/e′(S) and E/e′(L) with both dual gate Doppler and traditional method than controls. Compared with those in controls and AF non-recurrence group, E/e′(S) and E/e′(L) increased in AF recurrence group with both dual gate Doppler and traditional method (all P 0.05). Cut-off values of 10.90 (sensitivity of 71.4%, specificity of 87.5%) for E/e′(S) was obtained by dual gate Doppler and 10.70 (sensitivity of 81.0%, specificity of 62.5%) was obtained by traditional method for predicted AF recurrence. Areas under curves between the two methods in ROC analysis was not significant (0.819 vs 0.728, P>0.05). The whole analysis time of dual gate Doppler was less than that of traditional method. Between inter- and intraobservers, the interclass correlation coefficient with dual gate Doppler was higher and 95% confidence interval range was smaller. Conclusions E/e′(S) is a valuable predictor for PeAF recurrence after RFCA in patients with PeAF. Dual gate Doppler can noninvasively assess single-beat E/e′ with less analysis time and better reproducibility compared with traditional method. Key words: Echocardiography; Atrial fibrillation; Ventricular function, left; Dual gate Doppler