INTRODUCTION
Atrial fibrillation (AF) is the most common tachyarrhythmia, with an
estimated prevalence of 6% in patients older than 65 years, which is
progressively increasing because of aging of the population, higher
prevalence of risk factors and better strategies for
detection[1]. The presence of AF is associated
with a 2-fold increase in death and heart failure and a 5-fold increase
in the rates of stroke and systemic thromboembolism. Additionally, AF
can reduce quality of life and exercise
tolerance[2].
Catheter ablation (CA), one of the most commonly performed
electrophysiology procedures, has emerged as an important treatment
option for patients with AF. Randomized trials demonstrated the
superiority of CA compared to antiarrhythmic drugs in terms of
maintaining sinus rhythm (SR), improving the quality of life and
symptoms of AF patients and, the number of CA procedures grew
exponentially and indications are expanding[3].
Long-term success of CA varies widely from 50 to 80% and recurrences of
AF, mostly due to pulmonary vein reconnection, remain an important
problem. Prior studies have recognized a number of predictive outcomes
following CA of AF, such as age, type of AF, hypertension and left
atrial (LA) dilation[4].
AF is associated with LA enlargement, remodeling and fibrosis, caused by
LA pressure and/or volume overload[5].
Furthermore, LA structural and functional remodeling has been recognized
as an important risk factor for AF recurrence. In this regard, it is
interesting that LA strain, determined by 2-dimensional speckle tracking
echocardiography (2DSTE), can serve as a predictor for AF recurrence
after catheter ablation[6-7].
The aim of this meta-analysis is to evaluate the predictive role of LA
peak systolic longitudinal strain (LA-PLSsys) on AF recurrence after CA.