Does the E/e′ Index Predict the Maintenance of Sinus Rhythm after Catheter Ablation of Atrial Fibrillation?


  • Financial disclosure: This work was funded by grants from National Science & Technology Pillar Program of China in the 11th Five-Year Plan (grant number 2007BAI05B01) and Science & Technology Pillar Program of Sichuan Province (grant number 2009SZ0134).

Address for correspondence and reprint requests: Prof. Li Rao, M.D., Ph.D., Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, China. Fax: 86-28-85582944; E-mail:


Introduction: The role of left ventricular (LV) diastolic dysfunction in recurrent atrial fibrillation (AF) after catheter ablation remains unknown. We investigated LV diastolic function using the ratio of early transmitral flow velocity (E) to early diastolic mitral annular velocity (e′) and evaluated its predictive value for AF recurrence. Methods: One hundred three AF patients underwent transthoracic echocardiography before ablation and during 3 months of follow-up. Clinical and echocardiographic parameters of patients with maintained sinus rhythm were compared with those with recurrent AF. Results: Of 103 patients, 26 had recurrent AF during follow-up. The E/e′ index was the best independent predictor of AF recurrence in a multivariate logistic regression model. A cutoff value of 11.2 for the E/e′ measured before ablation was associated with a sensitivity of 80.8% and specificity of 81.8% (area under ROC curve, 0.840; 95% CI, 0.754–0.926) for AF recurrence. E/e′ measured in sinus rhythm after ablation had an even better predictive power (area under ROC curve, 0.917; 95% CI, 0.850–0.983). Conclusion: LV diastolic function was closely associated with AF recurrence after catheter ablation. The E/e′ index can be used as an incremental predictor for AF recurrence after catheter ablation. (Echocardiography 2010;27:630-636)