Low left atrial appendage emptying velocity is a predictor of atrial fibrillation recurrence after catheter ablation

摘要

Background: Recurrence of atrial fibrillation (AF) after catheter ablation (CA) remains common and studies have shown about 5-9 annual recurrence rate after CA. We sought to assess the echocardiogram derived left atrial appendage (LAA) emptying velocity as a predictor of AF recurrence after CA. Objective: To determine if LAA emptying is a marker of recurrence of AF post-CA Methods: A total of 303 consecutive patients who underwent CA for AF between 2014 and 2020 were included. Baseline clinical characteristics and echocardio-graphic data of the patients were obtained by chart review. LAA emptying velocities were obtained from transesophageal echocardiogram (TEE). LA voltage was obtained during the mapping for CA. Chi-square test and nominal logistic regression were used for statistical analysis. An receiver operator characteristic curve was used to determine LAA velocity cut-off. Results: Mean patient age was 61.7 ± 10.5; 32 were female. Mean LAA emptying velocity was 47.5 + 20.2. A total of 103 (40) patients had recurrence after CA. In the multivariable model, after adjusting for potential confounders, LAA emptying velocity of ≥52.3 was associated with decreased AF recurrence postablation (odds ratio OR: 0.55; 95 confidence interval Cl: 0.31-0.97; p = .03*). There were 190 (73) patients in normal sinus rhythm during TEE and CA, and sensitivity analysis of these patients showed that LAA velocity ≥52.3 remained associated with decreased AF recurrence (OR: 0.35; 95 Cl: 0.15-0.82; p = .01*). Conclusion: LAA emptying velocity measured during preprocedural TEE can serve as a predictor of AF recurrence in patients undergoing CA.