PMID- 27569695 OWN - NLM STAT- MEDLINE DCOM- 20171107 LR - 20220820 IS - 1540-8167 (Electronic) IS - 1045-3873 (Print) IS - 1045-3873 (Linking) VI - 27 IP - 12 DP - 2016 Dec TI - Association of Left Atrial Function Index With Late Atrial Fibrillation Recurrence after Catheter Ablation. PG - 1411-1419 LID - 10.1111/jce.13086 [doi] AB - INTRODUCTION: Although catheter ablation (CA) for atrial fibrillation (AF) is commonly used to improve symptoms, AF recurrence is common and new tools are needed to better inform patient selection for CA. Left atrial function index (LAFI), an echocardiographic measure of atrial mechanical function, has shown promise as a noninvasive predictor of AF. We hypothesized that LAFI would relate to AF recurrence after CA. METHODS AND RESULTS: All AF patients undergoing index CA were enrolled in a prospective institutional AF Treatment Registry between 2011 and 2014. LAFI was measured post hoc from pre-ablation clinical echocardiographic images in 168 participants. Participants were mostly male (33% female), middle-aged (60 +/- 10 years), obese and had paroxysmal AF (64%). Mean LAFI was 25.9 +/- 17.6. Over 12 months of follow-up, 78 participants (46%) experienced a late AF recurrence. In logistic regression analyses adjusting for factors known to be associated with AF, lower LAFI remained associated with AF recurrence after CA [OR 0.04 (0.01-0.67), P = 0.02]. LAFI discriminated AF recurrence after CA slightly better than CHADS2 (C-statistic 0.60 LAFI, 0.57 CHADS2). For participants with persistent AF, LAFI performed significantly better than CHADS2 score (C statistic = 0.79 LAFI, 0.56 CHADS2, P = 0.02). CONCLUSION: LAFI, an echocardiographic measure of atrial function, is associated with AF recurrence after CA and has improved ability to discriminate AF recurrence as compared to the CHADS-2 score, especially among persistent AF patients. Since LAFI can be calculated using standard 2D echocardiographic images, it may be a helpful tool for predicting AF recurrence. CI - (c) 2016 Wiley Periodicals, Inc. FAU - Sardana, Mayank AU - Sardana M AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Ogunsua, Adedotun A AU - Ogunsua AA AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Spring, Matthew AU - Spring M AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Shaikh, Amir AU - Shaikh A AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Asamoah, Owusu AU - Asamoah O AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Stokken, Glenn AU - Stokken G AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Browning, Clifford AU - Browning C AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Ennis, Cynthia AU - Ennis C AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Donahue, J Kevin AU - Donahue JK AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Rosenthal, Lawrence S AU - Rosenthal LS AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Floyd, Kevin C AU - Floyd KC AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Aurigemma, Gerard P AU - Aurigemma GP AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. FAU - Parikh, Nisha I AU - Parikh NI AD - Division of Cardiovascular Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA. FAU - McManus, David D AU - McManus DD AD - Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. LA - eng GR - R01 HL126911/HL/NHLBI NIH HHS/United States GR - UH2 TR000921/TR/NCATS NIH HHS/United States GR - UL1 TR001453/TR/NCATS NIH HHS/United States GR - KL2 TR000160/TR/NCATS NIH HHS/United States GR - R01 HL130376/HL/NHLBI NIH HHS/United States GR - KL2 RR031981/RR/NCRR NIH HHS/United States GR - R15 HL121761/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20161007 PL - United States TA - J Cardiovasc Electrophysiol JT - Journal of cardiovascular electrophysiology JID - 9010756 RN - 0 (Biomarkers) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM MH - Aged MH - Area Under Curve MH - Atrial Fibrillation/diagnostic imaging/physiopathology/*surgery MH - *Atrial Function, Left MH - Biomarkers/blood MH - *Catheter Ablation/adverse effects MH - *Echocardiography MH - Female MH - Heart Atria/diagnostic imaging/physiopathology/*surgery MH - Humans MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain/blood MH - Predictive Value of Tests MH - Prospective Studies MH - ROC Curve MH - Recurrence MH - Registries MH - Risk Factors MH - Time Factors MH - Treatment Outcome PMC - PMC5143220 MID - NIHMS815425 OTO - NOTNLM OT - arrhythmia recurrence OT - atrial fibrillation OT - atrial remodeling OT - catheter ablation OT - left atrial function index EDAT- 2016/08/30 06:00 MHDA- 2017/11/08 06:00 PMCR- 2017/12/01 CRDT- 2016/08/30 06:00 PHST- 2016/06/01 00:00 [received] PHST- 2016/07/27 00:00 [revised] PHST- 2016/08/12 00:00 [accepted] PHST- 2016/08/30 06:00 [pubmed] PHST- 2017/11/08 06:00 [medline] PHST- 2016/08/30 06:00 [entrez] PHST- 2017/12/01 00:00 [pmc-release] AID - 10.1111/jce.13086 [doi] PST - ppublish SO - J Cardiovasc Electrophysiol. 2016 Dec;27(12):1411-1419. doi: 10.1111/jce.13086. Epub 2016 Oct 7.