TY - JOUR

T1 - Usefulness of left atrial speckle tracking echocardiography in predicting recurrence of atrial fibrillation after radiofrequency ablation

T2 - a systematic review and meta-analysis

AU - Nielsen, Anne Bjerg

AU - Skaarup, Kristoffer Grundtvig

AU - Lassen, Mats Christian Højbjerg

AU - Djernæs, Kasper

AU - Hansen, Morten Lock

AU - Svendsen, Jesper Hastrup

AU - Johannessen, Arne

AU - Hansen, Jim

AU - Sørensen, Samuel Kiil

AU - Gislason, Gunnar

AU - Biering-Sørensen, Tor

PY - 2020/7

Y1 - 2020/7

N2 - The usefulness of peak atrial longitudinal strain (PALS) in identifying patients at high risk of atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA) has been investigated in several small AF populations. The aim of this systematic review and meta-analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment. MEDLINE, EMBASE and the Cochrane Library were searched. Studies investigating the value of PALS in predicting successful RFA in AF patients were selected. Patients underwent echocardiography prior to RFA. Risk of bias was evaluated using the Quality in Prognosis Studies (QUIPS) Tool. Twelve studies and a total of 1025 patients suffering from paroxysmal or persistent AF were included. Odds ratios (OR) were assessed in a random and fixed effects model for univariable and multivariable pooled analyses respectively. PALS was found to be a significant predictor of AF recurrence after RFA across study populations (Univariable: OR: 1.17, CI95% [1.03–1.34], p = 0.018, per 1% decrease) (Multivariable: OR: 1.16, CI95% [1.09–1.24], p < 0.001, per 1% decrease). Patients with recurrence had significantly lower PALS prior to RFA than patients who maintained sinus rhythm (15.7 ± 5.7% vs. 23.0 ± 7.0%, p = 0.016). A pooled analysis of weighted mean differences (WMD) also showed a significant difference in PALS between the two groups (WMD: − 6.57, CI95% [− 8.49: − 4.65], p < 0.001). Lower values of PALS are associated with an increased risk of AF recurrence after RFA. PALS provides prognostic value in clinical practice.

AB - The usefulness of peak atrial longitudinal strain (PALS) in identifying patients at high risk of atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA) has been investigated in several small AF populations. The aim of this systematic review and meta-analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment. MEDLINE, EMBASE and the Cochrane Library were searched. Studies investigating the value of PALS in predicting successful RFA in AF patients were selected. Patients underwent echocardiography prior to RFA. Risk of bias was evaluated using the Quality in Prognosis Studies (QUIPS) Tool. Twelve studies and a total of 1025 patients suffering from paroxysmal or persistent AF were included. Odds ratios (OR) were assessed in a random and fixed effects model for univariable and multivariable pooled analyses respectively. PALS was found to be a significant predictor of AF recurrence after RFA across study populations (Univariable: OR: 1.17, CI95% [1.03–1.34], p = 0.018, per 1% decrease) (Multivariable: OR: 1.16, CI95% [1.09–1.24], p < 0.001, per 1% decrease). Patients with recurrence had significantly lower PALS prior to RFA than patients who maintained sinus rhythm (15.7 ± 5.7% vs. 23.0 ± 7.0%, p = 0.016). A pooled analysis of weighted mean differences (WMD) also showed a significant difference in PALS between the two groups (WMD: − 6.57, CI95% [− 8.49: − 4.65], p < 0.001). Lower values of PALS are associated with an increased risk of AF recurrence after RFA. PALS provides prognostic value in clinical practice.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Echocardiography

KW - Imaging

KW - Meta-analysis

KW - Prognosis

U2 - 10.1007/s10554-020-01828-2

DO - 10.1007/s10554-020-01828-2

M3 - Journal article

C2 - 32248332

AN - SCOPUS:85084655549

VL - 36

SP - 1293

EP - 1309

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

ER -