Conventional versus 3‐D Echocardiography to Predict Arrhythmia Recurrence After Atrial Fibrillation Ablation

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Atrial fibrillation (AF) represents the most common sustained arrhythmia, which affects at least one percent of the general population.1 Its prevalence is projected to increase with the demographic changes and the growing burden of cardiovascular risk factors.1
Within the last two decades, catheter ablation (CA) has evolved into an established and efficient therapeutic option for paroxysmal and persistent AF.2 However, arrhythmia recurrence after initially successful procedures still requires repeat procedures in a substantial number of patients.2
Echocardiography represents a key tool for the assessment of cardiac structure and function.6 In the context of AF ablation, echocardiographic information is mandatory for appropriate patient selection and execution of the procedure. 8 In clinical routine, those exams usually include determination of underlying cardiac dimensions and function, presence of significant valvular disease or intracardiac thrombi prior to the procedure. 6 So far, various echocardiographic predictors for arrhythmia recurrence after CA have been described. Among those, left atrial (LA) dimensions and LA strain rate seem to be the most consistent.8 However, information on the predictive value of three‐dimensional (3‐D) echocardiographic information, such as shape and volumes, in this context has been very limited. Furthermore, it remains controversial if left ventricular dimensions, systolic and diastolic function assessed by echocardiography predict AF recurrence reliably.12
We therefore aimed to assess and compare the role of 3‐D and conventional echocardiography for prediction of arrhythmia recurrence in a large and well‐characterized cohort of AF patients undergoing CA.
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