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The Predictive Value of left atrial appendage peak flow velocity in Recurrence after initial radiofrequency catheter ablation of persistent atrial fibrillation: A single-center prospective study.

Background: Recurrence after Radiofrequency catheter ablation（RFCA） of
persistent atrial fibrillation (PeAF) is still elusive. The present
study aimed to evaluate the relationship between the left atrial
appendage peak flow velocity(LAAV) and atrial fibrillation(AF)
recurrences in PeAF patients after their initial RFCA. Method: This
study included 164 consecutive PeAF patients who performed initial RFCA
from January 2018 to December 2019. Transesophageal echocardiography was
used to collect the LAAV before ablation. Patients’ demographic and
clinical information was gathered. To detect the recurrences of AF,
patients were checked up at routine intervals. A Cox proportional
hazards regression analysis was adopted to evaluate the LAAV and other
clinical variables as predictors of AF recurrences throughout follow-up.
Results: AF recurrence resulted in 43 (26.2%) patients after a median
follow-up of 15 months (IQR: 12-18 months). LAAV reduced in patients
with AF recurrences (0.36±0.15m/s vs. 0.45±0.17m/s, P = 0.004). A
Kaplan-Meier study revealed that the low LAAV(≤0.37m/s) group had a
lower event-free survival rate than the high LAAV
(>0.37m/s) group (17.6 months vs. 21.2 months, Log Rank P =
0.002). LAAV≤0.37m/s (HR 2.32, 95%CI 1.177-4.227, P = 0.014) was found
to be independent predictors of AF recurrence after RFCA in the
multivariate Cox regression. Conclusion: A low LAAV is linked to AF
recurrence and acts as a predictor of AF recurrence after the initial
RFCA of peAF. This would aid in treatment strategy optimization and
management of patients with peAF.