TY - JOUR
T1 - Usefulness of left atrial speckle tracking echocardiography in predicting recurrence of atrial fibrillation after radiofrequency ablation
T2 - a systematic review and meta-analysis
AU - Nielsen, Anne Bjerg
AU - Skaarup, Kristoffer Grundtvig
AU - Lassen, Mats Christian Højbjerg
AU - Djernæs, Kasper
AU - Hansen, Morten Lock
AU - Svendsen, Jesper Hastrup
AU - Johannessen, Arne
AU - Hansen, Jim
AU - Sørensen, Samuel Kiil
AU - Gislason, Gunnar
AU - Biering-Sørensen, Tor
PY - 2020/7/1
Y1 - 2020/7/1
N2 - The usefulness of peak atrial longitudinal strain (PALS) in identifying patients at high risk of atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA) has been investigated in several small AF populations. The aim of this systematic review and meta-analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment. MEDLINE, EMBASE and the Cochrane Library were searched. Studies investigating the value of PALS in predicting successful RFA in AF patients were selected. Patients underwent echocardiography prior to RFA. Risk of bias was evaluated using the Quality in Prognosis Studies (QUIPS) Tool. Twelve studies and a total of 1025 patients suffering from paroxysmal or persistent AF were included. Odds ratios (OR) were assessed in a random and fixed effects model for univariable and multivariable pooled analyses respectively. PALS was found to be a significant predictor of AF recurrence after RFA across study populations (Univariable: OR: 1.17, CI95% [1.03-1.34], p = 0.018, per 1% decrease) (Multivariable: OR: 1.16, CI95% [1.09-1.24], p < 0.001, per 1% decrease). Patients with recurrence had significantly lower PALS prior to RFA than patients who maintained sinus rhythm (15.7 ± 5.7% vs. 23.0 ± 7.0%, p = 0.016). A pooled analysis of weighted mean differences (WMD) also showed a significant difference in PALS between the two groups (WMD: - 6.57, CI95% [- 8.49: - 4.65], p < 0.001). Lower values of PALS are associated with an increased risk of AF recurrence after RFA. PALS provides prognostic value in clinical practice.
AB - The usefulness of peak atrial longitudinal strain (PALS) in identifying patients at high risk of atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA) has been investigated in several small AF populations. The aim of this systematic review and meta-analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment. MEDLINE, EMBASE and the Cochrane Library were searched. Studies investigating the value of PALS in predicting successful RFA in AF patients were selected. Patients underwent echocardiography prior to RFA. Risk of bias was evaluated using the Quality in Prognosis Studies (QUIPS) Tool. Twelve studies and a total of 1025 patients suffering from paroxysmal or persistent AF were included. Odds ratios (OR) were assessed in a random and fixed effects model for univariable and multivariable pooled analyses respectively. PALS was found to be a significant predictor of AF recurrence after RFA across study populations (Univariable: OR: 1.17, CI95% [1.03-1.34], p = 0.018, per 1% decrease) (Multivariable: OR: 1.16, CI95% [1.09-1.24], p < 0.001, per 1% decrease). Patients with recurrence had significantly lower PALS prior to RFA than patients who maintained sinus rhythm (15.7 ± 5.7% vs. 23.0 ± 7.0%, p = 0.016). A pooled analysis of weighted mean differences (WMD) also showed a significant difference in PALS between the two groups (WMD: - 6.57, CI95% [- 8.49: - 4.65], p < 0.001). Lower values of PALS are associated with an increased risk of AF recurrence after RFA. PALS provides prognostic value in clinical practice.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Echocardiography
KW - Imaging
KW - Meta-analysis
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85084655549&partnerID=8YFLogxK
U2 - 10.1007/s10554-020-01828-2
DO - 10.1007/s10554-020-01828-2
M3 - Review
C2 - 32248332
SN - 1569-5794
VL - 36
SP - 1293
EP - 1309
JO - The international journal of cardiovascular imaging
JF - The international journal of cardiovascular imaging
IS - 7
ER -