Decreased left atrial global longitudinal strain predicts the risk of atrial fibrillation recurrence after cryoablation in paroxysmal atrial fibrillation

  • Hasan Koca
  • Abdullah Orhan Demirtas
  • Onur Kaypaklı
  • Yahya Kemal Icen
  • Durmus Yıldıray Sahin
  • Fadime Koca
  • Zikret Koseoglu
  • Ahmet Oytun Baykan
  • Emel Celiker Guler
  • Derya Demirtas
  • Mevlut KocEmail author



We aimed to investigate the association of atrial fibrillation (AF) recurrence with left atrial (LA) strain in nonvalvular paroxysmal AF patients after cryoablation.


We included 190 patients who underwent successful cryoablation due to paroxysmal AF. In addition to classical echocardiographic data, LA apical 2-chamber (A2C) strain, LA apical 4-chamber (A4C) strain, and LA global longitudinal strain (LA-GLS) values were calculated by speckle tracking echocardiography. Forty-eight-hour Holter monitoring was performed to all patients no later than 6 months after ablation.


AF recurrence was detected in 42 patients (22.1%). End-systolic diameter, LA end-systolic diameter, LA-volume, LA-volume index, interatrial septum thickness, coronary sinus diameter, epicardial fat thickness (EFT), and septal E/Eˋ ratio were significantly higher, LV-EF, IVRT, septal S and Aˋ wave, lateral S wave, LA-A2C strain, LA-A4C strain, and LA-GLS were significantly lower in patients with AF recurrence. LA-GLS, LA-volume index, and EFT were found to be independent parameters for predicting AF recurrence.


LA-GLS and LAVI should be included in routine evaluations to determine long-term AF recurrence preoperatively.


Paroxysmal atrial fibrillation Cryoablation Left atrial global longitudinal strain 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

The study was approved by the institutional ethics committee and complied with the principles of the Declaration of Helsinki.

Conflict of interest

The authors declare they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hasan Koca
    • 1
  • Abdullah Orhan Demirtas
    • 1
  • Onur Kaypaklı
    • 2
  • Yahya Kemal Icen
    • 1
  • Durmus Yıldıray Sahin
    • 1
  • Fadime Koca
    • 1
  • Zikret Koseoglu
    • 3
  • Ahmet Oytun Baykan
    • 4
  • Emel Celiker Guler
    • 1
  • Derya Demirtas
    • 5
  • Mevlut Koc
    • 1
    Email author
  1. 1.Department of CardiologyUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  2. 2.Department of Cardiology, Faculty of MedicineMustafa Kemal UniversityAntakyaTurkey
  3. 3.Department of Emergency MedicineUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  4. 4.Department of CardiologyOrtadogu Adana HospitalAdanaTurkey
  5. 5.Department of Internal MedicineUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey

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