Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. We sought to determine whether the post-procedural changes in LA function impact the risk of recurrence following AF ablation. We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. Peak left atrial contraction strain (PACS) and left atrial emptying fraction (LAEF) were evaluated during sinus rhythm and compared across the three time points. The primary endpoint was atrial tachyarrhythmia recurrence after ablation. A total of 144 patients were enrolled (mean age 61 ± 11 years, 77% male, 46% persistent AF). PACS and LAEF initially decreased 1-day following ablation but partially recovered within 3 months in PAF patients, with a similar trend in the PerAF patients. After median 24 months follow-up, 68 (47%) patients had recurrence. Patients with recurrence had higher PACS1-day than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS1-day -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan–Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS1-day was an independent risk factor of arrhythmia recurrence. Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS1-day post procedure predicts arrhythmia recurrence at long-term follow-up.

中文翻译：

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术后峰值左心房收缩应变预测心房颤动导管消融后心律失常的复发

心房颤动 (AF) 消融会损害左心房 (LA) 功能，并可能与复发风险相关。我们试图确定 LA 功能的术后变化是否会影响 AF 消融后的复发风险。我们回顾性分析了 2009 年至 2011 年间接受 AF 消融并在消融前、消融后 1 天和 3 个月期间接受经胸超声心动图检查的患者。在窦性心律期间评估峰值左心房收缩应变 (PACS) 和左心房排空分数 (LAEF)，并在三个时间点进行比较。主要终点是消融后房性快速心律失常复发。总共招募了 144 名患者（平均年龄 61 ± 11 岁，77% 为男性，46% 为持续性 AF）。PACS 和 LAEF 最初在消融后 1 天下降，但在 PAF 患者中在 3 个月内部分恢复，在 PerAF 患者中具有类似的趋势。中位随访 24 个月后，68 名（47%）患者出现复发。复发患者的 PACS1 天高于非复发受试者（-10.9 ± 5.0% 与 -13.4 ± 4.7%，p = 0.003）。PACS1 天 -12% 区分复发病例，敏感性为 67.7%，特异性为 60.5%。Kaplan-Meier 曲线显示 PACS ≥ -12% 和 PACS < -12% 的患者 5 年累积复发概率存在显着差异（对数等级 p < 0.0001）。多变量回归显示PACS1天是心律失常复发的独立危险因素。AF 消融后左心房功能立即恶化并在 3 个月内部分恢复，但在大多数患者中仍然异常。PACS 术后 1 天可预测长期随访中的心律失常复发。