Lower values of PALS are associated with an increased risk of AF recurrence after RFA .
PALS provides prognostic value in clinical practice
The usefulness of peak atrial longitudinal strain ( PALS ) in identifying patients at high risk of atrial fibrillation ( AF ) recurrence after radiofrequency ablation ( RFA )  has been investigated in several small AF population s. The aim of this systematic review and meta- analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment .
Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes.
The incremental value of left atrial ( LA ) deformation analysis by speckle tracking echocardiography compared with LA volume or LA ejection fraction as a cardiovascular risk marker has not been evaluated prospect ively . We sought to compare LA function by speckle tracking echocardiography to other conventional LA parameters for prediction of adverse cardiovascular outcomes . This prospect i ve study included 312 adults ( mean age 71 ± 6 years , 56 % men ) in sinus rhythm who were followed for development of first atrial fibrillation , congestive heart failure , stroke , transient ischemic attack , myocardial infa rct ion , coronary revascularization , and cardiovascular death .  Global peak atrial longitudinal strain ( PALS ) by speckle tracking echocardiography was measured in all subjects by averaging all atrial segments . Left atrium was assessed with biplane LA volume , LA ejection fraction , 4-chamber LA area , and M-mode dimension . Of 312 subjects at baseline , 43 had 61 new events during a mean follow-up of 3.1 ± 1.4 years . All LA parameters , traditional parameters , and parameters derived by speckle tracking echocardiography were independently predictive of combined outcomes ( p < 0.0001 for all comparisons ) . Overall performance for prediction of cardiovascular events was greatest for global PALS ( area under receiver operator characteristic curve : global PALS 0.83 , indexed LA volume 0.71 , LA ejection fraction 0.69 , LA area 0.64 , LA diameter 0.59 ) . A grade d association between degree of LA enlargement and risk of cardiovascular events was evident only for global PALS and indexed LA volume . In conclusion , global PALS is a strong and independent predictor of cardiovascular events and appears to be superior to conventional parameters of LA analysis
Lower values of PALS are associated with an increased risk of AF recurrence after RFA .
PALS provides prognostic value in clinical practice
The usefulness of peak atrial longitudinal strain ( PALS ) in identifying patients at high risk of atrial fibrillation ( AF ) recurrence after radiofrequency ablation ( RFA )  has been investigated in several small AF population s. The aim of this systematic review and meta- analysis was to investigate whether PALS predicts recurrence of AF after RFA treatment .