title: The predictive value of echocardiographic parameters associated with left ventricular diastolic dysfunction on short- and long-term outcomes of catheter ablation of atrial fibrillation.
abstract: OBJECTIVE
  Recurrence of atrial fibrillation (AF) is frequently observed after AF catheter ablation. However, the predictive value of echocardiographic parameters associated with left ventricular diastolic dysfunction (LVDD) has not been well studied.
  
  
  RESULTS
  In 124 consecutive patients (mean age 61 ± 10 years, 60% male) with paroxysmal (n = 70) or persistent AF (n = 54) undergoing AF catheter ablation, mitral early diastolic peak (E-wave) and late peak (A-wave) velocities, E/A ratio, deceleration time (DT) of mitral early velocity, early diastolic mitral annulus peak velocity (e'), and E/e' ratio were determined by transthoracic echocardiography. Early (ERAF) and late AF recurrence (LRAF) were monitored with 7-day Holter electrocardiograms directly after catheter ablation and after 6 and 12 months. Early AF recurrence occurred in 34% of the patients, while LRAF was observed in 27% of the patients. Patients with ERAF had higher E-wave (0.9 ± 0.2 vs. 0.8 ± 0.2 m/s, P = 0.035) and lower A-wave velocity (0.5 ± 0.2 vs. 0.6 ± 0.2 m/s, P = 0.038), higher E/A ratio (1.8 ± 0.9 vs. 1.5 ± 0.9, P = 0.089), and slower DT (214 ± 67 vs. 243 ± 68 ms, P = 0.073), while E/e', left atrial diameter, and left ventricular ejection fraction were similar. In multivariable regression analysis, the E/A ratio was the only independent predictor of ERAF (odds ratio 2.905, 95% confidence interval 1.072-7.870, P = 0.036). None of the echocardiographic parameters influenced the late therapy outcome.
  
  
  CONCLUSIONS
  Early results of the catheter ablation, but not the late rhythm outcome, are influenced by an impaired mitral inflow pattern, which is associated with LVDD.
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany jedrzejkosiuk@hotmail.com.
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Kosiuk
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Ole-A
authors.initials: OA
authors.lastname: Breithardt
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bode
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Jelena
authors.initials: J
authors.lastname: Kornej
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaspar
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D003971:Diastole; D015150:Echocardiography, Doppler; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Atrial fibrillation; Catheter ablation; Diastolic dysfunction; Echocardiography