title: Left atrial strain as predictor of successful outcomes in catheter ablation for atrial fibrillation: a two-dimensional myocardial imaging study.
abstract: BACKGROUND
  The objective of this study was to investigate atrial myocardial properties through two-dimensional (2D) myocardial imaging in patients with atrial fibrillation (AF) and its predictive role for recurrence after catheter ablation.
  
  
  RESULTS
  Echocardiographic examinations were performed in 40 patients with paroxysmal AF before catheter ablation and 40 age- and gender-matched healthy control subjects. Using a software package, bidimensional acquisitions were analyzed to measure longitudinal strain and strain rate for the left atrium (LA). Systolic strain and strain rate in all eight segments, and its average values, were significantly reduced in AF patients compared to controls. During 9 months of follow-up after catheter ablation for AF, 11 of 40 AF patients had AF recurrence. AF recurrence was associated with gender, LA volume index, and average values of systolic strain and strain rate. By multivariate analysis, only average strain was an independent predictor of AF recurrence (OR = 0.88, 95% CI 0.79-0.98, p = 0.018).
  
  
  CONCLUSIONS
  Lower systolic strain of LA was strongly associated with recurrence after catheter ablation. Thus, diverse adjunctive ablation strategies should be considered to reduce recurrence in patients with lower systolic strain.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Shinchon-dong 134, Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Sang Jae
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Lee
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Jaedeok
authors.initials: J
authors.lastname: Kim
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Sung Soon
authors.initials: SS
authors.lastname: Kim
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome