Association of atrial mechanical dispersion with atrial fibrillation recurrence following catheter ablation: results of the ASTRA-AF pilot study

• DOI: 10.1007/s00392-024-02435-0
• Publication Date: 2024-05-21T13:02:10Z
• Authors: Dorit Knappe; Julia Vogler; Jessica Weimann; Victor Banas; Sevenai Yildirim; Felix Memenga; Juliana Senftinger; Laura Keil; Djemail Ismaili; Moritz Nies; Andreas Rillig; Stephan Willems; Stefan Blankenberg; Paulus Kirchhof; Andreas Metzner; Christoph Sinning

Abstract

Aims For patients with symptomatic drug-refractory atrial fibrillation (AF), catheter ablation to achieve rhythm control is an important therapeutic option. The atrial mechanical dispersion measured as standard deviation of the time to peak strain (SD-TPS) is associated with the risk of AF recurrence following catheter ablation.

Methods The study cohort prospectively enrolled n = 132 consecutive patients with paroxysmal (n = 88) or persistent AF (n = 44) presenting for de novo pulmonary vein isolation (PVI) and followed for 1 year. We related left atrial (LA) volume, LA ejection fraction, SD-TPS, and global longitudinal strain of the left ventricle and clinical variables (sex, age, and type of AF) to AF recurrence.

Results Kaplan–Meier curves showed higher AF recurrence rate with an increase of SD-TPS with the calculated cut-off of 38.6 ms. Uni- and multivariable Cox regression analysis could show that SD-TPS had the highest relevance regarding AF recurrence with a HR of 1.05 (95% CI, 1.01; 1.09, p = 0.01) and HR of 1.05 (95% CI, 1.01; 1.09, p = 0.02) per 10 ms increase. In the additional analyses for the model including the clinical variables age, sex, and type of AF with paroxysmal or persisting AF, SD-TPS did only show a trend and after adjusting for covariates, SD-TPS showed a HR of 1.04 (95% CI, 0.99; 1.09, p = 0.09) per 10 ms increase.

Conclusion Atrial mechanical dispersion was associated with recurrent AF.

Graphical Abstract