Left atrial reservoir strain and recurrence of Atrial Fibrillation following De-Novo pulmonary vein isolation - rResults of the ASTRA-AF pilot study
Knappe, Dorit Vogler, Julia Weimann, Jessica Banas, Victor Obergassel, Julius Yildirim, Sevenai Memenga, Felix Senftinger, Juliana Keil, Laura Ismaili, Djemail
Knappe, Dorit
Vogler, Julia
Weimann, Jessica
Banas, Victor
Obergassel, Julius
Yildirim, Sevenai
Memenga, Felix
Senftinger, Juliana
Keil, Laura
Ismaili, Djemail
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Affiliation
University Heart and Vascular Center Hamburg; University Heart Center Lübeck; University Hospital Schleswig-Holstein Kiel; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2024-06-05
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Abstract
Background: Achieving early rhythm control and maintaining sinus rhythm are associated with improved outcomes in patients with atrial fibrillation (AF). Pulmonary vein isolation (PVI) is a validated alternative to medical rhythm control. This study determined associations between left atrial strain reservoir (LASR) and AF recurrence after PVI.Methods and Results: In all, 132 patients (88 with paroxysmal AF [PAF], 44 with persisting AF [PersAF]) who presented in sinus rhythm for de novo PVI of AF between December 2017 and January 2019 were included in the study. All patients underwent preprocedural echocardiography. After 12 months, all patients underwent 24-h Holter electrocardiogram monitoring to screen for AF recurrence. Kaplan-Meier curve analysis revealed an association between decreasing LASRand increased AF recurrence, with a cut-off at 31.4%. In univariable Cox regression analysis, LASRdemonstrated an association with AF recurrence, with hazard ratios (HR) of 0.83 (95% confidence interval [CI] 073-0.93; P=0.001) per 5% increase in univariable models and 0.83 (95% CI 073-0.95; P=0.005) in multivariable analysis. When clinical variables with age, sex and type of AF (PAF/PersAF) were included in the multivariable analysis, LASRremained relevant in a model with age (HR 0.86; 95% CI 073-1.00; P=0.046). Conclusions: In patients undergoing de novo PVI for AF, LASRcould be of use in risk stratification regarding AF recurrence.
Citation
Knappe D, Vogler J, Weimann J, Banas V, Obergassel J, Yildirim S, Memenga F, Senftinger J, Keil L, Ismaili D, Nies M, Rillig A, Willems S, Blankenberg S, Kirchhof P, Metzner A, Sinning C. Left Atrial Reservoir Strain and Recurrence of Atrial Fibrillation Following De-Novo Pulmonary Vein Isolation　- Results of the ASTRA-AF Pilot Study. Circ J. 2024 Jun 5. doi: 10.1253/circj.CJ-24-0209
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Article