Yu, An-LiAn-LiYuLiu, Yen-BinYen-BinLiuLI-TING HOHUI-CHUN HUANGLin, Lian-YuLian-YuLinHo, Yi-LwungYi-LwungHoKUAN-CHIH HUANGWEN-JONE CHENLai, Ling-PingLing-PingLaiLin, Lung-ChunLung-ChunLinYu, Chih-ChiehChih-ChiehYu2025-03-232025-03-232025-02-2409296646https://scholars.lib.ntu.edu.tw/handle/123456789/726014Background: To evaluate the correlation between atrial fibrillation (AF) burden and two-dimensional LA (left atrium) longitudinal reservoir strain (LARS) to explore the potential clinical utility of this novel parameter in patients with AF. Methods: This cross-sectional study was conducted at the cardiac electrophysiology clinic of a tertiary centre by consecutively enrolling patients with non-valvular AF. The AF burden was evaluated using 14-day patch-based electrocardiography and defined as the percentage of time spent in AF during a 14-day monitoring period. High and low AF burdens were defined based on the median 14-day AF burden. Echocardiographic measurements, including the longitudinal strain of the LA, were performed in all patients. Results: Among 267 patients, LARS was successfully performed in 221 (age 63 ± 11 years, male 71%, paroxysmal AF 71%). After adjusting for age, diabetes mellitus, congestive heart failure, estimated glomerular filtration rate, low-density lipoprotein level, left ventricular ejection fraction, LA dimension, and LA volume in multivariable linear regression analysis, low LARS remained a significant predictor of AF burden in addition to N-terminal pro-B-type natriuretic peptide and sex. Receiver operating curve analysis demonstrated that the best cut-off value for LARS to predict high AF burden (above median 10.49%) was 21.5%, with 75% sensitivity and 83% specificity. Conclusions: LARS is associated with the AF burden in patients with AF. Further studies are needed to determine the role of routine LARS measurements in such patients.entrueClinical monitoringLeft atrial strainPrognosisVentricular functionjournal article10.1016/j.jfma.2025.02.024400003502-s2.0-85218862990