Abstract
BACKGROUND: Catheter ablation (CA) leads to the recovery of left atrial (LA) function in patients with atrial fibrillation (AF), although the degree varies substantially among individuals. PA-TDI duration, the time delay between the P-wave on the electrocardiogram to the peak A'-wave on tissue-Doppler imaging of the lateral LA wall is an echocardiographic measure that reflects structural and electrical LA remodeling. OBJECTIVES: The objective of the study was to investigate whether the preprocedural PA-TDI duration could predict LA functional recovery after CA. METHODS: We studied 109 AF patients in sinus rhythm at preprocedural echocardiography, who underwent their first CA. PA-TDI duration was measured by tissue Doppler imaging from the apical four-chamber view. Speckle-tracking echocardiography was performed before and 6 months after CA to evaluate LA reservoir strain (LARS). RESULTS: The median (25th-75th percentile) PA-TDI duration was 144 (128-162) ms. There was no significant difference in age, sex, and AF risk factors between patients with longer PA-TDI duration (≥144 ms) and those with shorter PA-TDI duration (<144 ms). The median follow-up was 465 (273-746) days. LARS was significantly improved at 6 months after CA (29.7% ± 7.9% to 32.1% ± 6.7%; P < 0.001). Preprocedural PA-TDI duration was significantly associated with LARS at 6 months after CA independent of AF type, baseline LARS, and recurrent AF (standardized beta -0.20; 95% CI: -0.10 to -0.01; P = 0.013). Combination of baseline LARS and PA-TDI duration provided enhanced predictive value for postprocedural LA function (P < 0.001). CONCLUSIONS: The measurement of PA-TDI duration provided valuable information for LA functional recovery in AF patients who underwent CA.