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Left atrial strain assessed by three-dimensional speckle tracking echocardiography predicts atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation

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Abstract

Background

Several studies have shown the utility of left atrial (LA) function determined by two-dimensional or three-dimensional speckle tracking echocardiography (2D- or 3D-STE) for identifying patients with paroxysmal atrial fibrillation (AF). However, whether 3D-STE is applicable for prediction of the recurrence of AF after catheter ablation (CA) remains unknown. We examined whether any 3D-STE parameters are better than 2D-STE parameters for the prediction of AF recurrence.

Methods

Forty-two patients with paroxysmal AF (58 ± 10 years old, 69% male) underwent 2D- and 3D-STE within 3 days before first-time CA. The global peak LA longitudinal, circumferential, and area strains during systole (3D-GLSs, -GCSs, and -GASs, respectively) and those just before atrial contraction (3D-GLSa, -GCSa, and -GASa, respectively) were determined by 3D-STE and standard deviations of times to peaks of regional LA strains were calculated as indices of LA dyssynchrony. In 2D-STE, global LA longitudinal strains during systole and just before atrial contraction (2D-GLSs and -GLSa) were determined.

Results

During follow-up of 441 ± 221 days, 12 patients (29%) had AF recurrence. In the univariate Cox proportional hazard analysis, age [hazard ratio (HR): 1.08, p = 0.04], 3D-GCSs (HR: 0.91, p = 0.03), and 3D-GASs (HR: 0.95, p = 0.01) were predictors of AF recurrence, though associations of recurrence with 2D-STE parameters, indices of LA synchrony, and LA volume were not significant. Multivariable analysis showed that 3D-GASs was an independent predictor of AF recurrence (HR: 0.96, p = 0.048).

Conclusions

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.

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Acknowledgements

We thank the sonographers in the echocardiographic laboratory of Sapporo Medical University Hospital. We are grateful to the staff of Toshiba Medical Systems for their technical support.

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Authors and Affiliations

  1. Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan

    Atsushi Mochizuki, Satoshi Yuda, Takefumi Fujito, Atsuko Muranaka, Daigo Nagahara, Akiyoshi Hashimoto & Tetsuji Miura

  2. Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan

    Satoshi Yuda

  3. Department of Cardiology, Sapporo Hokushin Hospital, Sapporo, Japan

    Mina Kawamukai

  4. Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

    Daigo Nagahara

  5. Department of Cardiology, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan

    Shinya Shimoshige

  6. Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan

    Akiyoshi Hashimoto

Authors
  1. Atsushi Mochizuki
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  2. Satoshi Yuda
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  3. Takefumi Fujito
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  4. Mina Kawamukai
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  5. Atsuko Muranaka
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  6. Daigo Nagahara
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  9. Tetsuji Miura
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Corresponding author

Correspondence to Atsushi Mochizuki.

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Conflict of interest

This study was supported and endorsed by the Japanese Society of Echocardiography and was supported by Grants for Education and Research 2014 (no. 1501534) and 2015 (no. 1502406) from Sapporo Medical University, Sapporo, Japan. All of the authors have no conflict of interest to disclose in this study.

Human rights statement

All procedures followed were in accordance with the ethical standards of the institutional responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Mochizuki, A., Yuda, S., Fujito, T. et al. Left atrial strain assessed by three-dimensional speckle tracking echocardiography predicts atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation. J Echocardiogr 15, 79–87 (2017). https://doi.org/10.1007/s12574-017-0329-5

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  • DOI: https://doi.org/10.1007/s12574-017-0329-5

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