Abstract 18894: Standard Deviation of Segmental Left Atrial Strain is Impaired in Patients Treated by Pulmonary Vein Isolation With Late Failure
Introduction: Pulmonary vein isolation (PVI) has been established as effective interventional treatment in chronic atrial fibrillation (AF). Impairment of left atrial strain is considered a surrogate parameter of fibrosis. There is considerable variance of strain among different atrial wall segments. We hypothesized that early impairment of strain affects mobile segments and thus reduces inter-segmental variance of strain.
Methods: We evaluated 89 consecutive PVI patients and 28 controls (mean age 60 ± 12 y, 33 female). The longitudinal strain of the left atrium in a 4-chamber apical window was determined by speckle tracking (Philips IE33 offline analysis by QLAB™). Success was defined as maintenance of sinus rhythm until last follow-up (minimum 3 months elapsed since PVI). Follow-up comprised repeated Holter-monitoring and echocardiography. Variance was evaluated as standard deviation of segmental strain before PVI (STD).
Results: Atrial fibrillation recurred in 40 of 89 patients. STD was 16.5±7.9 in controls, 8.1±5.3 in PVI with persisting success and 4.6±2.2 in late PVI failure (see also box-plot).
The group differences between controls, PVI success and PVI failure were all significant (p<0.001 Kruskal-Wallis and median test) and improved prediction of PVI failure significantly in a binary logistic as well as linear discriminant model.
Conclusions: Standard deviation of segmental left atrial strain is impaired in patients treated by pulmonary vein isolation with late failure and should be further evaluated as predictor for recurrence.
Author Disclosures: M. Grafe: None. C. Kriatselis: None. H. Gerds-Li: None. J. Kaufmann: None. V. Furundzija: None. U. Thanabalasingam: None. E. Fleck: None. E. Wellnhofer: None.
- © 2014 by American Heart Association, Inc.