title: Left atrial strain predicts reverse remodeling after catheter ablation for atrial fibrillation.
abstract: OBJECTIVE
  The purpose of this study was to assess left atrial (LA) strain during long-term follow-up after catheter ablation for atrial fibrillation and to find predictors for LA reverse remodeling.
  
  
  BACKGROUND
  The association between LA reverse remodeling and improvement in LA strain after catheter ablation has not been investigated thus far.
  
  
  METHODS
  In 148 patients undergoing catheter ablation for atrial fibrillation, LA volumes and LA strain were assessed with echocardiography at baseline and after a mean of 13.2 ± 6.7 months of follow-up. The study population was divided according to LA reverse remodeling at follow-up: responders were defined as patients who exhibited 15% or more reduction in maximum LA volume at long-term follow-up. Left atrial systolic (LAs) strain was assessed with tissue Doppler imaging.
  
  
  RESULTS
  At follow-up, 93 patients (63%) were classified as responders, whereas 55 patients (37%) were nonresponders. At baseline, LAs strain was significantly higher in the responders as compared with the nonresponders (19 ± 8% vs. 14 ± 6%; p = 0.001). Among the responders, a significant increase in LAs strain was noted from baseline to follow-up (from 19 ± 8% to 22 ± 9%; p < 0.05), whereas no change was noted among the nonresponders. LAs strain at baseline was an independent predictor of LA reverse remodeling (odds ratio: 1.813; 95% confidence interval: 1.102 to 2.982; p = 0.019).
  
  
  CONCLUSIONS
  In the present study, 63% of the patients exhibited LA reverse remodeling after catheter ablation for atrial fibrillation, with a concomitant improvement in LA strain. LA strain at baseline was an independent predictor of LA reverse remodeling.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, the Netherlands.
authors.forename: Laurens F
authors.initials: LF
authors.lastname: Tops
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Den Uijl
authors.forename: Serge A I P
authors.initials: SA
authors.lastname: Trines
authors.forename: Katja
authors.initials: K
authors.lastname: Zeppenfeld
authors.forename: Eduard
authors.initials: E
authors.lastname: Holman
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D016279:Atrial Function, Left / Q000502:physiology*; D017115:Catheter Ablation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D020257:Ventricular Remodeling / Q000502:physiology*