Abstract 14467: Left Atrial Functional Index is a Predictor of Persistent/permanent Non-valvular Atrial Fibrillation

Introduction: Chronicity of atrial fibrillation (AF) has been associated with poor cardiovascular outcomes. Left atrial function index (LAFI) is a rhythm-independent measure of LA reservoir function adjusted for LA size and stroke volume and is an established marker of risk for cardiac disease states. We sought to evaluate the role of LA function by LAFI in predicting persistent/permanent AF. Hypothesis: LAFI is a predictor of chronicity of AF. Methods: Patients attending our institution between Jan 2013 and Dec 2017 were assessed. Patients with history of non-valvular AF who received transthoracic echocardiogram (TTE) evaluation were included. In these patients, we evaluated demographic profiles, AF history, clinical comorbidities and echocardiographic data. We excluded patients with valvular AF, poor quality TTE images and incomplete clinical data. Results: Of the 665 patients (67.78±13.62years, 52% male) included, 27.8% had persistent/permanent AF. Persistent/permanent AF was associated with older age (p<0.01), heart failure (p<0.01), diabetes mellitus (p=0.02), ischaemic heart disease (p=0.02), obstructive sleep apnoea (p=0.04), renal impairment (p<0.01), lower left ventricular ejection fraction (p<0.01), higher E/e’ (p<0.01), larger LA volume index (p<0.01) and lower LAFI (p<0.01). Multi-variable analysis revealed both heart failure (OR 3.024, 95%CI 1.737 to 5.265, p<0.01) and LAFI (OR 4.881, 95%CI 2.503 to 9.519, p<0.01) as independent predictors of persistent/permanent AF. Receiver operating characteristic curve showed LAFI (see Figure; AUC 0.75, 95%CI 0.703 to 0.793, p<0.01) of less than 16.5 to have a 70% sensitivity and 70% specificity in detecting persistent/permanent AF. Conclusions: LAFI, an echocardiographic measure of atrial mechanical function, may be a useful tool in risk stratification for patients with non-valvular AF.