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A. Basics
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01. History of Cardiology
02. Clinical Skills
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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28. Risk Factors and Prevention
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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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The prognostic value of left atrial size and strain in predicting atrial fibrillation recurrence at 6 and 12 months after pulmonary vein isolation
Session:
Sessão de Posters 20 - Gestão moderna de arritmias: do mapeamento à monitorização
Speaker:
Ana Marta C. Pinto
Congress:
CPC 2026
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Ana Lucy Calvo; Luísa Pinheiro; Emídio Mata; Bárbara Lage Garcia; Ana Marta Pinto; Filipa Castro; Margarida de Castro; Mário Lourenço; Ana Sofia Gonçalves; Sílvia Ribeiro; Olga Azevedo; António Lourenço
Abstract
<p>Introduction: Left atrial (LA) volume and LA strain (LAS) offer insights into structural and functional changes of the LA and may help predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). </p> <p>Aim: To assess the predictive value of pre-procedural LA morpho-functional echocardiographic parameters in determining AF recurrence at 6 and 12 months post-PVI. </p> <p>Methods: Single-center retrospective study analyzing AF patients who underwent initial PVI (2015-2024), with available pre-procedural echocardiogram. LAS and volume measurements were reviewed, and AF recurrence at 6 and 12 months was determined using available 12-lead ECG and Holter monitoring. Receiver operating characteristic analysis assessed the predictive value of LA parameters. </p> <p>Results: Seventy-two patients met inclusion criteria; follow-up was available for 60 at 6 months and 51 at 12 months. Median echocardiography-to-PVI interval was 312 days [IQR 120–610]. AF recurrence occurred in 9 (15.0%) and 15 (29.4%) patients at 6 and 12 months, respectively. </p> <p>At 6 months, indexed LA diameter had the highest predictive value (AUC 0.68, p=0.21; optimal cutoff >24.3 mm/m²; sensitivity 57.1%; specificity 91.7%), followed by Indexed LA end-diastolic volume (AUC 0.64, p=0.26; cutoff >41 mL/m²; sensitivity: 55.6%; specificity: 85%). Among strain parameters, LAS of conduit (LAScd) performed best (AUC 0.64, p=0.28; cutoff ≤7.8%; sensitivity: 60%; specificity: 80.6%), whereas LAS of reservoir (LASr) and LAS of contraction (LASct) showed limited discrimination (AUCs 0.59 and 0.54). </p> <p>At 12 months, indexed LA diameter was the only significant predictor (AUC 0.72, p=0.02; cutoff >23.6 mm/m²; sensitivity 53.9%; specificity 90.6%). indexed LA end-diastolic volume (AUC 0.67, p=0.07) and LAScd (AUC 0.66, p=0.11) demonstrated moderate, non-significant predictive ability. </p> <p>Discussion: Despite some echocardiographic parameters showing moderate discriminatory ability, none achieved robust statistical significance except for the indexed LA diameter at 12 months. These findings are likely influenced by several limitations, including potential selection bias, a small sample size reducing statistical power, and patient dropout during follow-up. Moreover, variability in the interval between echocardiographic assessment and PVI may have affected the accuracy of pre-procedural measurements in predicting long-term outcomes. </p>
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