Left atrial spontaneous echo contrast (LASEC) is known as one of markers of thrombogenic milieu in patients with atrial fibrillation (AF). In recent study, LASEC is related with recurrence of atrial fibrillation after cardioversion. But it was not examined that SEC has a influence on the recurrence of AF after radiofrequency catheter ablation (RFCA).
Method
132 patients with non-valvular persistent AF who underwent catheter ablation for AF were enrolled and performed trans-thoracic echocardiography (TTE) and trans-esophageal echocardiography (TEE) before procedure. SEC was diagnosed by TEE as the presence of smoke-like echogenic materials which swirled in the cavities. And other 2D-echocardiography parameters were measured. We correlated the presence of SEC with recurrence and other echocardiographic parameter.
Result
Ablation time was longer in patients with SEC than in patients without SEC (173±57 min vs. 133±39 min, p-value=0.004). LA appendage (LAA) emptying velocity and emptying fraction (EF) were significantly decreased in patients with SEC (40.5±12.1 cm/sec vs. 21.9±7.2 cm/sec and 34.3±9.8 %vs. 17.7±7 %, p-value <0.001 and 0.039)
The presence of SEC was related with recurrence of AF after procedure (Odd ratio=2.48, p-value=0.17). Moderately increased LAVI (defined as >30 ml/m2), impaired LAEF (defined as LAEF<30%), decreased LAA emptying velocity (defined as < 30 cm/sec) and decreased LAA EF (defined as< 30%) were correlated with the presence of SEC (r=0.26, 0.25, 0.65 and 0.63, p-value=0.003, 0.005, <0.001 and <0.001)
Multivariated analysis demonstrated that only decreased LAA emptying velocity was significant influencing factor on the presencse of SEC (p-value= 0.001)
|
