Abstract 16650: Pre-Procedural Atrial Electromechanical Delay Assessed by Tissue Doppler Imaging Predicts Atrial Fibrillation Recurrence After Catheter Ablation
Background: Atrial remodeling is thought to limit the efficacy of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). Echocardiographic assessment of the atrial electromechanical delay has been proposed as a measure of atrial remodeling and is a potential predictor of AF recurrence after RFCA.
Objectives: To study the impact of pre-procedural electromechanical delay on the efficacy of RFCA for AF.
Methods: In 92 patients undergoing RFCA for symptomatic drug-refractory paroxysmal AF, baseline atrial electromechanical coupling was assessed on echocardiography by measuring the time delay between the onset of the p-wave in lead II of the surface ECG and the peak A'-wave on the Tissue Doppler tracing of the left atrial lateral wall (PA-TDI). During a 12 months follow-up, AF recurrence was monitored and defined as any registration of AF on ECG or an episode of AF longer than 30 seconds on 24-hour Holter monitoring. Accordingly, the prognostic value of baseline PA-TDI to predict AF recurrence after RFCA was studied.
Results: During follow-up, 65 patients (71%) maintained sinus rhythm and 27 patients (29%) had AF recurrence. In the non-recurrence group less atrial electromechanical delay was found compared to the recurrence group (PA-TDI: 127.1 ± 21.2 ms versus 141.5 ± 22.3 ms, p=0.004). After adjustment for heart rate, the corrected atrial electromechanical delay was lower in the non-recurrence group compared to the recurrence group (cPA-TDI: 126.5 ± 22.5 ms versus 139.8 ± 18.3 ms, p=0.008).
Conclusion: Pre-procedural atrial electromechanical delay predicts AF recurrence after RFCA.
- © 2010 by American Heart Association, Inc.