Title

Low left atrial appendage emptying velocity is a predictor of atrial fibrillation recurrence after catheter ablation

Authors

Sahith Reddy Thotamgari, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Aakash Rajendra Sheth, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Javaria Ahmad, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Danish Bawa, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Sindhu Thevuthasan, Division of Cardiology, Department of Medicine, and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Akhilesh Babbili, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Mohammad Alfrad Bhuiyan, Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Vijaywant Brar, Division of Cardiology, Department of Medicine, and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Narendra Duddyala, Division of Cardiology, Hendrick Health, Abilene, Texas, USA.
Allen Amorn, Division of Cardiology, Department of Medicine, and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Paari Dominic, Division of Cardiology, Department of Medicine, and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.

Document Type

Article

Publication Date

8-1-2022

Abstract

BACKGROUND: Recurrence of atrial fibrillation (AF) after catheter ablation (CA) remains common and studies have shown about 5%-9% annual recurrence rate after CA. We sought to assess the echocardiogram derived left atrial appendage (LAA) emptying velocity as a predictor of AF recurrence after CA. OBJECTIVE: To determine if LAA emptying is a marker of recurrence of AF post-CA METHODS: A total of 303 consecutive patients who underwent CA for AF between 2014 and 2020 were included. Baseline clinical characteristics and echocardiographic data of the patients were obtained by chart review. LAA emptying velocities were obtained from transesophageal echocardiogram (TEE). LA voltage was obtained during the mapping for CA. Chi-square test and nominal logistic regression were used for statistical analysis. An receiver operator characteristic curve was used to determine LAA velocity cut-off. RESULTS: Mean patient age was 61.7 ± 10.5; 32% were female. Mean LAA emptying velocity was 47.5 ± 20.2. A total of 103 (40%) patients had recurrence after CA. In the multivariable model, after adjusting for potential confounders, LAA emptying velocity of ≥52.3 was associated with decreased AF recurrence postablation (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.31-0.97; p = .03*). There were 190 (73%) patients in normal sinus rhythm during TEE and CA, and sensitivity analysis of these patients showed that LAA velocity ≥52.3 remained associated with decreased AF recurrence (OR: 0.35; 95% CI: 0.15-0.82; p = .01*). CONCLUSION: LAA emptying velocity measured during preprocedural TEE can serve as a predictor of AF recurrence in patients undergoing CA.

Publication Source (Journal or Book title)

Journal of cardiovascular electrophysiology

First Page

1705

Last Page

1711

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