The 'battle' against paroxysmal atrial fibrillation: Is there a role for left atrial mechanical dyssynchrony evaluated by speckle tracking?

摘要

Although several studies have shown that in patients with paroxysmal AF (PAF), pulmonary vein isolation (PVI) alone is sufficient to achieve freedom from AF [1, 2], in some patients, success rate is not satisfactory even after multiple procedure [3].Several studies sought to assess predictors of AF ablation failure in the setting of PAF [3, 4].Although left atrial (LA) size, female gender, obesity, presence of scar detected by low amplitude electrograms, voltage mapping, and MRI have been proposed as a predictor of AF ablation failure, several considerations arise [3, 4].Unpublished data from our group and from others have shown that around 20/30 % of paroxysmal patients fail ablation procedures if these are limited to pulmonary vein isolation.