Assessment of left atrial mechanical dispersion by real-time 3D echocardiography combined with DR-FLASH score for predicting late recurrence after ablation in paroxysmal atrial fibrillation

Acta Cardiol. 2025 Jun 11:1-10. doi: 10.1080/00015385.2025.2516944. Online ahead of print.

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia causing serious health complications. Catheter ablation is used to treat AF, but the risk of recurrence is high. The DR-FLASH score, which predicts recurrence, has limited sensitivity and specificity. Left atrial mechanical dispersion (LAMD) is an effective index that reflects the synchronisation of left atrial mechanical movement and the degree of early remodelling.

Objective: This study aimed to assess the predictive value of LAMD and the DR-FLASH score for late recurrence after ablation.

Methods: The general clinical data, structural, and functional parameters of both the recurrence group and the non-recurrence group were collected. Univariate and multivariate logistic regression analysis explored the independent predictors of late recurrence after AF ablation. The ROC curve was used to evaluate the effectiveness of LAMD and DR-FLASH score on recurrence after AF ablation.

Results: The study included 102 AF patients and 31 healthy controls. LAMD was found to be an independent predictor of recurrence, and combining it with the DR-FLASH score improved predictive efficiency, with an area under the curve (AUC) of 0.875, sensitivity of 77.8%, and specificity of 88.0%.

Conclusion: LAMD combined with the DR-FLASH score can help identify high-risk patients and potentially reduce recurrence rates.

Keywords: Atrial fibrillation; DR-FLASH score; left atrial mechanical dispersion; recurrence.