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 echo...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2015-07, Vol.32 (7), p.1101-1108 |
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| creator | Fukushima, Keiko Fukushima, Noritoshi Ejima, Koichiro Kato, Ken Sato, Yasuto Uematsu, Shoko Arai, Kotaro Manaka, Tetsuyuki Takagi, Atsushi Ashihara, Kyomi Shoda, Morio Hagiwara, Nobuhisa |
| description | 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. |
| doi_str_mv | 10.1111/echo.12823 |
| format | Article |
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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. <131.0 msec; hazard ratio [HR]: 2.477, 95% confidence interval [CI]: 1.031–5.950; P = 0.042), and in the lowest tertile of LAAFV compared with the highest tertile (<48.5 cm/sec vs. ≥64.9 cm/sec; HR: 2.680, 95% CI: 1.136–6.318; P = 0.024). The risk of AF recurrence was also higher in the highest tertile of LAVI (≥34.2 mL/m2) compared with the lowest tertile, but this difference was not significant (HR: 2.146, 95% CI: 0.834–5.523; P = 0.113).
Conclusions
LAAFV (reflecting functional remodeling) and PA‐TDI (reflecting electrical remodeling) are independent predictors of AF recurrence after RFCA for PAF.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.12823</identifier><identifier>PMID: 25362992</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Atrial Appendage - diagnostic imaging ; Atrial Appendage - physiopathology ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Atrial Remodeling ; Catheter Ablation ; Echocardiography, Doppler ; Female ; Humans ; left atrial appendage flow velocity ; left atrial volume index ; Male ; Middle Aged ; paroxysmal atrial fibrillation ; Postoperative Complications - diagnosis ; Postoperative Complications - physiopathology ; Predictive Value of Tests ; Preoperative Care ; Prospective Studies ; radiofrequency catheter ablation ; Recurrence ; Risk Assessment ; Time Factors ; total atrial conduction time</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2015-07, Vol.32 (7), p.1101-1108</ispartof><rights>2014, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4373-331bbbcdac447f9cf39770d12b329853ce2a706b2e2cf106c634bb25ea38e08c3</citedby><cites>FETCH-LOGICAL-c4373-331bbbcdac447f9cf39770d12b329853ce2a706b2e2cf106c634bb25ea38e08c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.12823$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.12823$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25362992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fukushima, Keiko</creatorcontrib><creatorcontrib>Fukushima, Noritoshi</creatorcontrib><creatorcontrib>Ejima, Koichiro</creatorcontrib><creatorcontrib>Kato, Ken</creatorcontrib><creatorcontrib>Sato, Yasuto</creatorcontrib><creatorcontrib>Uematsu, Shoko</creatorcontrib><creatorcontrib>Arai, Kotaro</creatorcontrib><creatorcontrib>Manaka, Tetsuyuki</creatorcontrib><creatorcontrib>Takagi, Atsushi</creatorcontrib><creatorcontrib>Ashihara, Kyomi</creatorcontrib><creatorcontrib>Shoda, Morio</creatorcontrib><creatorcontrib>Hagiwara, Nobuhisa</creatorcontrib><title>Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>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. <131.0 msec; hazard ratio [HR]: 2.477, 95% confidence interval [CI]: 1.031–5.950; P = 0.042), and in the lowest tertile of LAAFV compared with the highest tertile (<48.5 cm/sec vs. ≥64.9 cm/sec; HR: 2.680, 95% CI: 1.136–6.318; P = 0.024). The risk of AF recurrence was also higher in the highest tertile of LAVI (≥34.2 mL/m2) compared with the lowest tertile, but this difference was not significant (HR: 2.146, 95% CI: 0.834–5.523; P = 0.113).
Conclusions
LAAFV (reflecting functional remodeling) and PA‐TDI (reflecting electrical remodeling) are independent predictors of AF recurrence after RFCA for PAF.</description><subject>Atrial Appendage - diagnostic imaging</subject><subject>Atrial Appendage - physiopathology</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Atrial Remodeling</subject><subject>Catheter Ablation</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Humans</subject><subject>left atrial appendage flow velocity</subject><subject>left atrial volume index</subject><subject>Male</subject><subject>Middle Aged</subject><subject>paroxysmal atrial fibrillation</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - physiopathology</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>radiofrequency catheter ablation</subject><subject>Recurrence</subject><subject>Risk Assessment</subject><subject>Time Factors</subject><subject>total atrial conduction time</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EokNhwwMg70BIKf5J4mQ5Sjsd0MBUVWmXlu3cUEMSp7bTMo_EW5Ih7Sy5myud-52jKx2E3lJyQqf5BObWnVBWMP4MLWiWkqSgInuOFkSkLJl0doRehfCTECIoTV-iI5bxnJUlW6A_G2giXkZvVYuXwwB9rX4AXrXuAV9D64yNO6z6Gl_ZDnDjXYcvkht1D3jbB4g4uukSwgj41A1DCz45BW_vocbL9_jCQ23NIX5ltbdtq6J1Pb4EM3oPvQGsmggeX6rausbD3TiJO1ypeAt7falnx2v0olFtgDeP-xh9X51dVetksz3_XC03iUm54AnnVGttamXSVDSlaXgpBKkp05yVRcYNMCVIrhkw01CSm5ynWrMMFC-AFIYfow9z7uDd9EuIsrPBwPR3D24MkuZlWuaMZXRCP86o8S4ED40cvO2U30lK5L4aua9G_qtmgt895o66g_qAPnUxAXQGHmwLu_9EybNqvX0KTWaPDRF-HzzK_5K54CKTN9_O5br6ytbl6lp-4X8BhFyqRw</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Fukushima, Keiko</creator><creator>Fukushima, Noritoshi</creator><creator>Ejima, Koichiro</creator><creator>Kato, Ken</creator><creator>Sato, Yasuto</creator><creator>Uematsu, Shoko</creator><creator>Arai, Kotaro</creator><creator>Manaka, Tetsuyuki</creator><creator>Takagi, Atsushi</creator><creator>Ashihara, Kyomi</creator><creator>Shoda, Morio</creator><creator>Hagiwara, Nobuhisa</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201507</creationdate><title>Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation</title><author>Fukushima, Keiko ; Fukushima, Noritoshi ; Ejima, Koichiro ; Kato, Ken ; Sato, Yasuto ; Uematsu, Shoko ; Arai, Kotaro ; Manaka, Tetsuyuki ; Takagi, Atsushi ; Ashihara, Kyomi ; Shoda, Morio ; Hagiwara, Nobuhisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4373-331bbbcdac447f9cf39770d12b329853ce2a706b2e2cf106c634bb25ea38e08c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Atrial Appendage - diagnostic imaging</topic><topic>Atrial Appendage - physiopathology</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Atrial Remodeling</topic><topic>Catheter Ablation</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Humans</topic><topic>left atrial appendage flow velocity</topic><topic>left atrial volume index</topic><topic>Male</topic><topic>Middle Aged</topic><topic>paroxysmal atrial fibrillation</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - physiopathology</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>radiofrequency catheter ablation</topic><topic>Recurrence</topic><topic>Risk Assessment</topic><topic>Time Factors</topic><topic>total atrial conduction time</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukushima, Keiko</creatorcontrib><creatorcontrib>Fukushima, Noritoshi</creatorcontrib><creatorcontrib>Ejima, Koichiro</creatorcontrib><creatorcontrib>Kato, Ken</creatorcontrib><creatorcontrib>Sato, Yasuto</creatorcontrib><creatorcontrib>Uematsu, Shoko</creatorcontrib><creatorcontrib>Arai, Kotaro</creatorcontrib><creatorcontrib>Manaka, Tetsuyuki</creatorcontrib><creatorcontrib>Takagi, Atsushi</creatorcontrib><creatorcontrib>Ashihara, Kyomi</creatorcontrib><creatorcontrib>Shoda, Morio</creatorcontrib><creatorcontrib>Hagiwara, Nobuhisa</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukushima, Keiko</au><au>Fukushima, Noritoshi</au><au>Ejima, Koichiro</au><au>Kato, Ken</au><au>Sato, Yasuto</au><au>Uematsu, Shoko</au><au>Arai, Kotaro</au><au>Manaka, Tetsuyuki</au><au>Takagi, Atsushi</au><au>Ashihara, Kyomi</au><au>Shoda, Morio</au><au>Hagiwara, Nobuhisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2015-07</date><risdate>2015</risdate><volume>32</volume><issue>7</issue><spage>1101</spage><epage>1108</epage><pages>1101-1108</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>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. <131.0 msec; hazard ratio [HR]: 2.477, 95% confidence interval [CI]: 1.031–5.950; P = 0.042), and in the lowest tertile of LAAFV compared with the highest tertile (<48.5 cm/sec vs. ≥64.9 cm/sec; HR: 2.680, 95% CI: 1.136–6.318; P = 0.024). The risk of AF recurrence was also higher in the highest tertile of LAVI (≥34.2 mL/m2) compared with the lowest tertile, but this difference was not significant (HR: 2.146, 95% CI: 0.834–5.523; P = 0.113).
Conclusions
LAAFV (reflecting functional remodeling) and PA‐TDI (reflecting electrical remodeling) are independent predictors of AF recurrence after RFCA for PAF.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25362992</pmid><doi>10.1111/echo.12823</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0742-2822 |
| ispartof | Echocardiography (Mount Kisco, N.Y.), 2015-07, Vol.32 (7), p.1101-1108 |
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| source | MEDLINE; Wiley Journals |
| subjects | Atrial Appendage - diagnostic imaging Atrial Appendage - physiopathology Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Atrial Remodeling Catheter Ablation Echocardiography, Doppler Female Humans left atrial appendage flow velocity left atrial volume index Male Middle Aged paroxysmal atrial fibrillation Postoperative Complications - diagnosis Postoperative Complications - physiopathology Predictive Value of Tests Preoperative Care Prospective Studies radiofrequency catheter ablation Recurrence Risk Assessment Time Factors total atrial conduction time |
| title | Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation |
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