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.