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Updated: Jan 25, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Diastolic wall strain predicts progression from paroxysmal to persistent or permanent atrial fibrillation in

Shunsuke Uetake1, Mitsunori Maruyama1, Tatsuya Mitsuishi1

  • 1Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.

Journal of Cardiology
|April 25, 2019
PubMed

Insights

Left ventricular compliance, measured by diastolic wall strain (DWS), predicts atrial fibrillation (AF) progression. Lower DWS indicates higher risk, suggesting earlier radiofrequency catheter ablation (RFCA) may benefit these patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Clinical Research

Background:

  • Atrial fibrillation (AF) progression is linked to increased morbidity, mortality, and poorer radiofrequency catheter ablation (RFCA) outcomes.
  • Left ventricular (LV) compliance, assessed by diastolic wall strain (DWS), was previously identified as a determinant of prevalent AF.

Purpose of the Study:

  • To investigate the association between LV compliance (DWS) and the progression of paroxysmal atrial fibrillation.
  • To identify predictors of AF progression in patients with structurally normal hearts.

Main Methods:

  • A cohort of 306 patients with paroxysmal AF and normal heart structure was studied.
  • Non-invasive echocardiography was used to measure DWS.
  • Patients were followed for 35±19 months, with outcomes compared between medication-only and RFCA groups.

Main Results:

  • AF progression occurred in 35% of the medication group versus 2% in the RFCA group (p<0.001).
  • In the medication group, DWS <0.38 was associated with a higher incidence of AF progression (log-rank p<0.001).
  • DWS and left atrium volume index (LAVI) were independent predictors of AF progression in the medication group.

Conclusions:

  • LV compliance, estimated by DWS, is independently associated with AF progression.
  • DWS can stratify patients at risk for AF progression, identifying those who may benefit from earlier RFCA.
Abstract

Keywords:
Atrial fibrillationEchocardiographyPrognosisProgression

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