Tissue Doppler Imaging and 2D Speckle Tracking as a Predictor of Successful Outcomes after Catheter Ablation for Atrial Fibrillation

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Background: Recently, tissue Doppler imaging and 2D speckle tracking method have been used to evaluate the electrical and mechanical function of the left atrium (LA). Methods: We conducted echocardiographic evaluation in 40 atrial fibrillation (AF) patients (16 non-paroxysma AF; age, 61±10 years; 32 male) undergoing catheter ablation (CA). Before and 1–3 months after CA, we measured LA volume (LAV), E/E′, PA-TDI interval (from the initiation of the P wave to the A′ wave on the lateral left atrial tissue Doppler tracking), LA average strain by velocity vector imaging. Results: In 17 patients with AF recurrence, longer PA-TDI interval, larger LAV and E/E′ were observed before CA than in those without recurrence (174±35 ms versus 148±20 ms, P=0.0119) (63±28 cm³ versus 37±12 cm³, P=0.0005) (9.1±3.0 versus 6.4±1.7, P=0.0021). Tissue velocities of the A′ wave were lower in patients with recurrence (7.2±1.8 cm/s versus 11.7±2.8 cm/s, P=0.0014). There were no significant differences in other parameters. The A′ wave, LAV and LA average strain were significantly improved after CA, however, the PA-TDI interval remained unchanged after ablation. Conclusion: The greater PA-TDI interval, LAV and E/E′ and the decreased A′ wave could be useful to identify patients at high risk of AF recurrence after ablation.