In patients with paroxysmal atrial fibrillation left atrial strain paramethers, left atrial function index and poor glycaemic control can be predictors of arrhythmia recurrence Free

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Left atrial (LA) systolic dysfunction is present in early stages of atrial fibrillation (AFib) prior to left anatomical changes and is influenced by left ventricular systolic function. We evaluate weather left atrial function index (LAFI), left atrial strain parameters (LASP) and glycemic control can be a predictor of AFib recurrence after medical or electrical conversion patients with paroxysmal AFib.

We evaluate 150 patients who underwent medical or electrical conversion for paroxysmal AFIb, for a period of 2 years. LA systolic function was appreciated with the echocardiography determined LA emptying volume = Maximum LA volume (LAV max)-minimum LA volume (LAV min), LA emptying fraction= {[LAV max-LAV min]/LAV max]x100}, and LAFI = LA emptying fraction x LVOT-VTILA max index. Left atrial strain (LAS) was assessed as reservoir strain[normal value(NV) 39%], conduit strain(NV 23%) and contractile strain(NV 17%). Flow mediated vasodilation was recorded at the level of brachial artery. Recurrent AFib was recorded in 75 patients (50%), time11,5 ± 10 month.

Univariate analysis revealed as markers for arrhythmia recurrence low LAFI, reduced LA ejection force, altered LASP, high BMI, poor glycemic control (cut-off value for hemoglobin HbA1C 7%), high BMI, decreased index of flow mediated vasodilatation (FMD). On multivariate analysis poor glycemic control, reduced LAFI, altered LASP and larger LA diameter had a higher risk of AFib than patients with higher LAFI and good glycemic control (p < 0,004).

In patients with paroxysmal atrial fibrillation, reduced left atrial function index, altered left atrial strain parameters, larger left atrium, altered endothelial dysfunction appreciated by flow mediated vasodilatation, and poor glycemic control can be predictors of arial fibrillation recurrence.