Reduced LA strain predicts atrial fibrillation recurrence after catheter ablation : a systematic review and meta-analysis

• Background and Aim: Despite the improved outcome of patients with atrial fibrillation (AF) who undergo catheter ablation, recurrence of the arrhythmia remains a concern. The aim of this meta-analysis was to assess the potential association between left atrial (LA) strain and AF recurrence after ablation.Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to December 2016 in order to identify clinical trial and observational studies, which assessed the predictive role of LA strain in AF recurrence after catheter-ablation. The search identified 898 patients form 10 studies, with paroxysmal AF (PAF) and persistent AF (PeAF).Results: The pooled analysis showed that after a follow-up period of 11.8± 8.1 months, patients with AF recurrence had reduced LA strain compared with those without AF, with a weighted mean difference (WMD) -7.04% ([95% CI -9.62 to -4.45], P < 0.0001). A subgroup analysis showed that LA strain was reduced regardless of AF type; WMD was -5.47% ([95% CI -9.82% to -1.13%], P=0.003) in PAF and -7.88% ([95% CI -11.19% to -4.56%], P < 0.001) in PAF/PeAF, the difference between these two subgroups was not significant (Chi2=0.75, I2=0.0%, p=0.39). A cut off value of 21% [6% to 30%], was 79% [65-86%] sensitive and 77% [66% to 91%] specific for predicting AF recurrence.Conclusions: Reduced LA strain significantly predicts recurrence of AF after ablation procedure, irrespective of AF type. This emphasizes the impact of LA wall remodeling on successful ablation.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

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