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Background—The increasing prevalence of atrial fibrillation (AF) represents a public health issue. Identifying new predictors of AF is therefore necessary to plan preventive strategies. We investigated whether left ventricular (LV) systolic dysfunction by global longitudinal strain (GLS), a predictor of cardiovascular events, may predict new-onset AF in a population setting. Methods and Results—Participants (n=675; mean age, 71±9 years; 60% women) in sinus rhythm from the population-based Northern Manhattan Study (NOMAS) underwent 2- and 3-dimensional echocardiography as part of the Cardiac Abnormalities and Brain Lesions (CABL) study. LV systolic function was assessed by LV ejection fraction and speckle-tracking GLS. During a mean follow-up of 63.6±18.7 months, 32 (4.7%) new confirmed cases of AF occurred. Lower GLS (adjusted hazard ratio/unit decrease, 1.22; 95% confidence interval, 1.04–1.43; P=0.015) and increased left atrial volume index (LAVi; adjusted hazard ratio/unit increase, 1.12; 95% confidence interval, 1.07–1.17; P<0.001) were significantly associated with incident AF, whereas LV ejection fraction was not (P=0.176). Abnormal GLS (>–14.7%) was associated with risk of new-onset AF with an adjusted hazard ratio of 3.2 (95% confidence interval, 1.4–7.5; P=0.007). The coexistence of abnormal GLS/abnormal LAVi was associated with a 28.6% incidence of AF (adjusted hazard ratio, 12.1; 95% confidence interval, 3.3–44.8; P<0.001) compared with participants with normal GLS/normal LAVi (AF incidence, 2.0%). AF incidence was intermediate in those with either abnormal GLS or abnormal LAVi (9.3% and 11.1%, respectively). GLS prognostic value for incident AF was incremental over risk factors and LAVi. Conclusions—LV systolic dysfunction by GLS was a powerful and independent predictor of incident AF. GLS assessment may improve AF risk stratification in addition to established parameters.

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation