Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Background Atrial fibrillation (AF) is associated with atrial remodeling. We investigate the abilities of preprocedural echocardiographic parameters reflecting atrial remodeling to predict AF recurrence after radiofrequency catheter ablation (RFCA) for paroxysmal AF (PAF). Methods Preprocedural echocardiographic parameters were measured during sinus rhythm in 105 patients with PAF undergoing RFCA. Electrical remodeling was assessed by the time from the onset of the P‐wave to the peak A′‐wave on the tissue Doppler imaging (PA‐TDI), functional remodeling was assessed by the left atrial appendage flow velocity (LAAFV), and structural remodeling was assessed by the left atrial volume index (LAVI). PA‐TDI, LAAFV, and LAVI values were divided into tertiles, and their abilities to predict AF recurrence were assessed using Cox regression analysis. Results AF recurrence occurred in 39/105 (37.1%) patients. After adjustment for confounders, the rate of AF recurrence was significantly higher in the highest tertile of PA‐TDI compared with the lowest tertile (≥151.3 msec vs.