Peak left atrial longitudinal strain and incident atrial fibrillation in the general population: a systematic review and meta-analysis

Background: Atrial fibrillation (AF) is the commonest supraventricular arrhythmia in adults. Timely AF diagnosis seems to ameliorate patients prognosis. Purpose: To investigate the association between peak left atrial longitudinal strain (PALS) and new onset AF in the general population. Objectives: We searched major electronic databases for articles assessing the relationship between PALS and incident AF. Results: Eight studies (11,145 patients) were analysed. Lower levels of PALS were significantly associated with higher risk of incident AF (HR: 0.95; 95%CI: 0.92-0.97, I2: 83%). According to the diagnostic accuracy meta-analysis, PALS <33.4% presents 64% (95%CI: 46-79%) sensitivity and 69% (95%CI: 63-75%) specificity. Conclusions: In a relatively healthy population, lower levels of PALS were significantly associated with incident AF. The overall diagnostic accuracy was moderate. Lower levels of PALS seem to justify an opportunistic - rather than a systematic-screening approach. These findings could allow more efficient utilisation of healthcare resources.