Opinion Review
Copyright ©The Author(s) 2022.
World J Clin Cases. Aug 16, 2022; 10(23): 8063-8075
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8063
Table 1 Predictors of atrial fibrillation recurrence after catheter ablation
Methods
Parameters
BiomarkersC-reactive protein
Fibrinogen
B-type natriuretic peptide
Oxidative stress
Homocysteine and endothelin-1
Renin-angiotensin-aldosterone system
ECG parametersP-wave duration
Intra-atrial conduction time
Dispersion of atrial fibrillation cycle lengths
Imaging parametersEchocardiographic parametersLeft atrial diameter
Left atrial volume
Mitral inflow patterns
E/e’ index
Left atrial electromechanical conduction time
LA appendage ejectionfraction
Left atrial expansion index
Strain/strain rate
MRI and CT imagingPericardial fat
Left atrial fibrosis
Ablation-related scarring
Pulmonary vein anatomy
Table 2 Left atrial strain in the prediction of atrial fibrillation recurrence after catheter ablation
Ref.
Year (of data acquisition)
Population
Sample size (n)
Technology
Conclusion
Wen et al[77] (2021) 2009-2011America1442D-STEPatients with recurrence had higher LASct 1-d than that in non-recurrence subjects LASct 1-d post-procedure predicts arrhythmia recurrence at long-term follow-up
Uziębło-Życzkowska et al[72] (2021) 2019-2020Poland1722D-STELASr and LASct were all associated with LA increased pressure in AF patients after CA
Pilichowska-Paszkiet et al[71] (2021) July 2011 to January 2014Poland2082D-STEIn patients with PAF, parameters reflecting LA compliance LASr and LAScd are independent and strong predictors of CA outcome
Koca et al[76] (2020) follow-up 1 yrTurkey1902D-STELA strain in both 2 chambers and 4 chambers, and GALS were significantly lower in patients with AF recurrence. GALS should be included in routine evaluations to determine long-term AF recurrence preoperatively
Hanaki et al[74] (2020) January 2013 to December 2016Japan1002D-STEIn patients with long-standing PeAF, the inability to restore SR and lower LASr after AAD/ECV treatment independently and incrementally predicts the recurrence after CA
Csécs et al[65] (2020) Follow-up 3 moAmerica55CMRPeak longitudinal atrial strain was significant predictor of arrhythmia recurrence and arrhythmia recurrence
Yan et al[64] (2019) October 2016 to December 2017China322D-STEThe strain rates in the lateral wall base segment, interval middle segment, and middle segment of the lateral wall and GALS were significantly decreased in the patients with AF recurrence
Chen et al[6] (2019) May 2015 to June 2016China402D-STEThe LA reservoir, conduit and contractile strain in septal segments significantly decreased in the PAF patients with low-voltage zone after CA. Besides, global strain tended to be an independent determinant of LA fibrosis
Bai et al[78] (2018) 2013-2014China872D-STEPeak right atrial longitudinal strain, peak LA longitudinal strain, and combined both are important factors associated with AF recurrence following CA in patients with chronic lung diseases
Parwani et al[62] (2017) January 2010 to January 2013Germany1022D-STEPatients with recurrence of atrial arrhythmias after both the first and the second CA procedure had significantly lowered LA strain than those without recurrence
Mochizuki et al[39] (2017) February 2013 to December 2014Japan423D-STEIn both the PAF and PeAF populations, patients with recurrence presented with significantly impaired GALS compared with patients without recurrence. LA strain determined by 3D-STE is a novel and better predictor of AF recurrence after CA than that determined by 2D-STE or other known predictors
Ma et al[57] (2017) March 2013 to March 2015China1152D-STEPatients with recurrence presented with significantly impaired GALS compared with patients without recurrence. In both PAF and PeAF, decreased baseline LA deformation capabilities assessed by 2D-STE can help to identify patients at high risk of AF recurrence after catheter ablation
Habibi et al[66] (2016) January 2011 to September 2013America121CMRLA reservoir function was independently associated with recurrent AF/AT after PVI. Peak LA strain improved prediction of recurrent AT/AF compared to the baseline clinical model
Gucuk Ipek et al[69] (2016) 2010-2013America119CMRBaseline reservoir, conduit, and contractile function of the LA were significantly impaired in patients with incident LA flutter
Yasuda et al[63](2015)July 2010 to March 2012Japan1002D-STEPatients with AF recurrence had significantly a lower LA global strain and lower LA lateral total strain than those who maintained sinus rhythm. LA global strain could predict AF recurrence after CA
Montserrat et al[24] (2015) Follow-up 6 moSpain832D-STELASr and LASct were significantly lower in the second RFCA patients. LASr independent predictor of arrhythmia suppression after first RFCA and after a second RFCA
Motoki et al[75] (2014) June 2008 to May 2010Australia3192D-STEPatients with LA total strain < 23.2% showed a higher incidence of AF recurrence. baseline LA total strain was associated with rhythm outcome after catheter ablation
La Meir et al[59] (2013) 2007-2011Netherlands332D-STEThe peak systolic strain and the peak strain rate were lower in patients with atrial fibrillation than in the controls. It had increased significantly at 3 mo and 12 mo after surgery
Hammerstingl et al[23] (2012) 2008-2010Germany1032D-STEThe assessment of global LA strain with 2D-STE identifies patients with a high risk for AF recurrence after ablation procedures
Tops et al[60] (2011) Follow-up 12 moNetherlands1222D-STE63% of the patients exhibited LA reverse remodeling after CA for AF, with a concomitant improvement in LA strain. LA strain at baseline was an independent predictor of LA reverse remodeling
Mirza et al[79] (2011) January 2005 to April 2009America632D-STEglobal and regional systolic and diastolic strains and SR were reduced in patients with recurrent AF. Regional LA lateral wall LS is a preprocedural determinant of AFR in patients undergoing CA, independent of LA enlargement
Hwang et al[73] (2009) Follow-up 9 moKorea402D- STEThe lower systolic strain of LA was strongly associated with recurrence after catheter ablation
Schneider et al)[61] (2008)March 2003 to October 2006Germany1182D-STEPatients with higher atrial strain and SR after catheter ablation appear to have a greater likelihood of maintenance of sinus rhythm