Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
Title Predictive value of the total atrial conduction time estimated with tissue Doppler imaging for predicting atrial tachyarrhythmia recurrences after catheter ablation
Conference The Annual Congress of the European Heart Rhythm Association (EHRA 2018)
Promoters The European Heart Rhythm Association (EHRA)
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type General
Publisher and common publisher◎EJIMA Koichiro, HIGUCHI Satoshi, IWANAMI Yuji, YAGISHITA Daigo, ARAI Kotaro, SAITO Chihiro, TANINO Sae, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa
Date 2018/03/19
(city and name of the country)
Barcelona, SPAIN
Society abstract European Heart Journal Supplements 20(Supplement 1),i125 2018
Summary *Session Title: Atrial fibrillation ablation - New tools and strategies for lesion creation and evaluation

Background: The estimated total atrial conduction time measured using tissue Doppler imaging of the atria (PATDI duration) has been proposed as a marker of atrial remodeling.

Purpose: To investigate the prognostic value of the echocardiographic parameters, including the PA­TDI duration, obtained before paroxysmal atrial fibrillation (AF) ablation procedures, to predict atrial tachyarrhythmia recurrences after the procedure.

Methods and Results: We enrolled 294 consecutive patients (60±11 years; 213 men) with paroxysmal AF who underwent AF ablation and measured the pre­procedural PA­TDI duration. All patients underwent a circumferential pulmonary vein isolation without either an empiric substrate modification or empiric left atrial linear ablation. During 38±21 months of follow­up after the final procedure (two procedures in 31%, three in 3%), 39 (13%) patients had atrial tachyarrhythmia recurrences. Eighteen patients who did not undergo repeat procedures despite AF recurrences after the first session were excluded from the analysis. A multivariate Cox regression analysis including the age, gender, structural heart disease, left atrial volume index, and PA­TDI duration as variables, demonstrated that the PA­TDI duration was an independent predictor of a recurrence (p<0.0001). The optimal cut­off value of the PA­TDI duration for predicting a recurrence was >151.0ms, with a sensitivity of 90%, specificity of 65%, and negative predictive value of 99%. Recurrences after repeat procedures were significantly higher in the patients with a PA­TDI duration >151.0ms compared to those with a PA­TDI duration <151.0ms (Log­rank; p<0.0001). The patients with a PA­TDI duration >151ms had a 13­ fold (p<0.0001) increase in the probability of recurrent AF as compared to the patients with a PA­TDI duration <151ms.

Conclusion: The PA­TDI duration was a useful predictor of recurrences after ablation procedures in patients with paroxysmal AF.