The left atrial function index: a rhythm independent marker of atrial function

Aims This study evaluates a simple echocardiographic rhythm independent expression of left atrial (LA) function, 'the left atrial function index' (LAFI). Background Quantitation of LA function is challenging and often established parameters including peak A are limited to sinus rhythm (SR). We hypothesized that atrial function could be characterized independent of rhythm by combining analogues of LA volume, reservoir function and LV stroke volume. Methods Seventy-two patients with chronic atrial fibrillation (CAF) were followed for six months post cardioversion (CV). Thirty-seven age matched healthy subjects were controls. The LAR = LAEF x LVOT-VTI/LAESVI (LAEF = LA emptying fraction, LAESVI = maximal LA volume indexed to BSA, LVOT-VT1 = outflow tract velocity time integral). Results The LAFI pre-CV in the CAF group was depressed vs controls (0.10 +/- 0.05 vs 0.54 +/- 0.17; P = 0.0001). Post-CV, LAFI was tower in persistent AF than in those restored to SR (AF vs SR: 0.08 +/- 0.03 vs 0.15 +/- 0.08; P = 0.0001), improved progressively in SR and was unchanged when AF persisted. Conclusion The LAFI, a simple, rhythm independent expression of atrial function, appears sensitive to differences between individuals in AF and those restored to SR and justifies clinical and investigative applications.