Assessment of left atrial appendage function by strain-Doppler-transesophageal echocardiography in atrial fibrillation pre-post- direct current cardioversion or pulmonary vein isolation

Background. The utility of transesophageal echo (TEE) in assessing left atrial (LA) or left atrial appendage (LAA) function is well known in patients with atrial fibrillation undergoing direct current cardioversion (DCC) but its utility in patients undergoing pulmonary vein isolation (PVI) is uncertain. Methods. 64 patients (pts) with AF before DCC (38 pts) or PVI (26 pts) were studied. Patients were grouped into those who remained in sinus rhythm (group 1, n =35) and those who had AF recurrence between 1 and 6 months after cardioversion (group 2, n= 19) or ablation (group 3, n= 10). Strain rate imaging (SRI) of the basal LA wall was performed. Systolic (SR-S) and early diastolic (SR-E) deformation were determined. Left atrial appendage emptying (LAA-EV) and filling (LAA-FV) velocities and peak pulmonary venous systolic wave velocity (PV-SV) were also obtained. Results. SR-E was significantly lower in group 2 than group 1 (p