Incremental value of right atrial strain analysis to predict atrial fibrillation recurrence after electrical cardioversion

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is the most frequent cardiac arrhythmia, associated with elevated risks cardiovascular events and death. The assessment left atrial (LA) mechanics has been reported to refine AF risk prediction, however it does not completely predict relapse. potential added role right (RA) function in this setting unknown. Purpose This study sought evaluate value RA longitudinal reservoir strain (RARS), on top LA (LARS) analysis, for prediction recurrence after electrical cardioversion (ECV). Methods We retrospectively studied 132 consecutive adult patients (men 55%, 72±10 years) persistent undergoing ECV hospital setting. Exclusion criteria were: pregnancy, previous surgery, pacemaker or implantable cardioverter defibrillator, severe valvular regurgitation/stenosis, ventricular systolic dysfunction, poor apical acoustic window, unsuccessful ECV, early recurrent lack follow-up. size were analyzed by conventional 2D speckle-tracking echocardiography before ECV. endpoint was recurrence. Results After a total follow-up 12 months, 63 (48%) showed Both significantly lower experiencing than sinus rhythm (LARS 10±6 vs 13±7%, RARS 14±10 20±9 %, respectively, p<0.001 both). By receiving operating curve (ROC) best cut-offs 15% [AUC 0.77 (95%CI 0.69–0.84), p<0.0001] 10% LARS 0.69 (95%IC 0.60–0.77), p<0.0001]. Kaplan-Meier curves that both LARS≤10% ≤15% had significant recurrences (log-rank, p<0.001) (Figure 1). However, at multivariable Cox regression, [HR 3.26, 95%CI (1.73–6.13), p< 0.001] only parameter independently provided incremental prognostic over LARS, volumes concerning relapse 2). Conclusions an LARS. highlights importance assessing functional remodeling AF. Figure 1. freedom according strain. plots grouped threshold levels (left panel) (right values identified Receiver Operating Curve analyses.