Left atrial ventricular coupling index combined with left atrial strain assessment can predict the risk of recurrence after radiofrequency ablation for atrial fibrillation
LIU Lanyuan
QIN Tao
ZHENG Sulin
ZHONG Yuanlin
GAO Wanyi
CHENG Sheng
ZHONG Jiankai
Abstract：Objective To investigate the predictive value of the left atrioventricular coupling index(LACI)combined with left atrial strain parameters-reservoir strain(LASr),conduit strain(LAScd),and contractile strain(LASct)-for recurrence of atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA).Methods A total of 154 patients with AF who underwent RFCA at the Eighth Affiliated Hospital of Southern Medical University from October 2022 and December 2024 were enrolled.Based on recurrence within 6 months post-procedure,patients were divided into a recurrence group(n=38)and a non-recurrence group(n=116).Baseline data and echocardiographic parameters were compared between the two groups.Changes in LACI,LASr,LAScd,and LASct were assessed before and one month after RFCA.Generalized estimating equations and Cox regression models were used to analyze their influence on recurrence.ROC curves were employed to evaluate predictive performance,and Kaplan-Meier curves were plotted to analyze recurrence rates.Results The recurrence group had larger left atrial diameters and higher E/e'ratios(P<0.05).At one-month post-ablation,the non-recurrence group showed a more pronounced decrease in LACI and greater improvement in LASr,LASct,and LAScd(P<0.05).LACI and the left atrial strain parameters were identified as independent predictors of recurrence.ROC curve analysis demonstrated that the combined model of the four indicators yielded a higher area under the curve(AUC=0.836)than any individual parameter:LASr(AUC=0.735),LASct(AUC=0.754),LAScd(AUC=0.703),or LACI(AUC=0.776).Kaplan-Meier analysis indicated that patients with LACI≤33.91%,LASr>25.86%,LASct>|-11.83%|,and LAScd>|-14.46%|had significantly lower recurrence rates(P<0.05).Conclusion LACI,LASr,LASct,and LAScd serve as valuable predictors of AF recurrence after RFCA.Their combined assessment improves predictive accuracy and aids in individualized postoperative risk management.
Keywords：left atrioventricular coupling indexleft atrial strainatrial fibrillationradiofrequency catheter ablation
Publication Date：2025-12-20
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：9( 1497-1505 )