Transesophageal echocardiography measures left atrial appendage volume and function and predicts recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation

Aims Paroxysmal atrial fibrillation ( PAF ) commonly recurs after radiofrequency catheter ablation ( RFCA ). This study aimed to assess left atrial appendage ( LAA ) volume and function by transesophageal echocardiography ( TEE ) and to explore its value in predicting PAF recurrence after RFCA . Methods Eighty patients with PAF were recruited. The left atrial ( LA ) and LAA volume and function were measured by transthoracic echocardiography ( TTE ) and TEE before ablation. Patients were followed up for 12 months after RFCA , and recurrence was recorded. Odds ratios of candidate risk indicators were determined by logistic regression analysis. Prediction model was constructed using logistic regression with backward selection. Receiver operating characteristic ( ROC ) curve with area under curve ( AUC ) was performed to evaluate the prediction efficiency. Results Twenty‐four (30%) PAF patients had recurrence (R group), and 56 (70%) patients had no recurrence ( NR group). Compared to NR group, LA dimension ( LAD ), LA volume index ( LAVI ), LAA maximum volume ( LAAV max), and LAA minimum volume ( LAAV min) were significantly higher in R group, while LAA peak emptying flow velocity ( LAA eV), LAA peak filling flow velocity ( LAA fV), and LAA ejection fraction ( LAAEF ) significantly declined in R group. According to multivariate analysis and backward selection, LAVI , LAAEF , and LAA eV were significant risk factors for PAF recurrence. The LAVI  +  LAAEF  +  LAA eV joint model could effectively predict PAF recurrence with AUC of 0.893 (95% confidence interval = 0.816, 0.970), sensitivity of 0.75, and specificity of 0.929. Conclusions This study demonstrated that LAVI , LAAEF , and LAA eV were significant predictors of PAF recurrence after RFCA .