Abstract 16249: Low Left Atrial Appendage Wall Velocity Obtained By Trans-Thoracic Echocardiography Predicts the Recurrence of Paroxysmal Atrial Fibrillation After Catheter Ablation
Introduction: The pulmonary vein isolation (PVI) is a promising therapy for the paroxysmal atrial fibrillation (PAF), whereas the rate of PAF recurrence remains relatively high after PVI. It was reported that left atrial (LA) remodeling was associated with left atrial appendage (LAA) dysfunction and recurrence of PAF after PVI. However, the feasible predictor for PAF recurrence remains to be determined. We previously reported that LAA wall motion velocity obtained by transthoracic echocardiography (TTE-LAWV) can noninvasively and easily evaluate LAA dysfunction and useful for the detection of LAA thrombus. We hypothesized that TTE-LAWV can predict the PAF recurrence after PVI.
Methods: We performed TTE and transesophageal echocardiography (TEE) in 182 PAF patients who were admitted to our hospital for first PVI (132 males, 59 ± 9 years). TTE-LAWV was measured using Doppler tissue imaging at the LAA tip from the parasternal short-axis view on TTE imaging, as previously reported. We excluded the patients who had low ejection fraction, severe valvular heart disease, old myocardial infarction and cardiomyopathy.
Results: The recurrence of PAF was observed in 64 (35.2%) patients after PVI. Patients with the recurrence of PAF had lower TTE-LAWV, increased left atrial volume index, and lower LAA emptying flow velocity (LAA eV) compared to those without before PVI. TTE-LAWV was significantly correlated with LAA eV and LAWV by TEE (R = 0.391, P < 0.05 and R = 0.756, P < 0.05). Cox multivariate hazard analysis showed that TTE-LAWV was an independent predictor for recurrence of PAF after PVI (hazard ratio 1.89, 95% confidence interval 1.28 - 2.87, P < 0.05). Kaplan-Meier analysis showed that a higher PAF recurrence rate was observed in patients with low TTE-LAWV (<14.5 cm/s) compared with those with high TTE-LAWV (≥14.5 cm/s) (Figure).
Conclusion: TTE-LAWV can noninvasively evaluate LAA dysfunction and may be useful predictor for recurrence of PAF after PVI.
Author Disclosures: N. Hashimoto: None. H. Tamura: None. T. Watanabe: None. Y. Kumagai: None. N. Hashimoto: None. M. Wanezaki: None. G. Yamaura: None. S. Nishiyama: None. T. Arimoto: None. T. Iwayama: None. H. Takahashi: None. T. Shishido: None. T. Miyamoto: None. I. Kubota: None.
- © 2016 by American Heart Association, Inc.