PURPOSE: Recurrence of atrial fibrillation (AF) after catheter ablation is common, being clinically relevant to identify predictors of recurrence. The left atrial appendage (LAA) role as an AF trigger is scarcely explored. Our aim was to identify if LAA volume is an independent predictor of AF recurrence after catheter ablation. METHODS: We analysed 52 patients (aged 54 ± 10 years, 58% male) with paroxysmal and persistent AF who underwent a first AF catheter ablation and had performed contrast-enhanced cardiac computed tomography (CT) prior to the procedure. RESULTS: The mean left atrial and LAA volumes measured by cardiac CT were 98.9 ± 31.8 and 9.3 ± 3.5 mL, respectively. All patients received successful pulmonary vein isolation and were followed up for 24 months. AF recurrence occurred in 17 patients (33%). LAA volume was significantly greater in patients with AF recurrence than in those without recurrence (11.3 ± 2.9 vs. 8.2 ± 3.4 mL; p = 0.002). Multivariable analysis using Cox regression revealed that LAA volume (hazard ratio 1.32; 95% confidence interval 1.12-1.55; p = 0.001) and persistent AF (hazard ratio 4.22; 95% confidence interval 1.48-12.07; p = 0.007) were independent predictors for AF recurrence. An LAA volume greater than 8.825 mL predicted AF recurrence with 94% sensitivity and 66% specificity. The Kaplan-Meier analysis showed a lower rate free from AF recurrence in the group with an LAA volume >8.825 mL (p < 0.001). CONCLUSIONS: Larger LAA volume was associated with AF recurrence after catheter ablation in patients with paroxysmal and persistent AF.
PURPOSE: Recurrence of atrial fibrillation (AF) after catheter ablation is common, being clinically relevant to identify predictors of recurrence. The left atrial appendage (LAA) role as an AF trigger is scarcely explored. Our aim was to identify if LAA volume is an independent predictor of AF recurrence after catheter ablation. METHODS: We analysed 52 patients (aged 54 ± 10 years, 58% male) with paroxysmal and persistent AF who underwent a first AF catheter ablation and had performed contrast-enhanced cardiac computed tomography (CT) prior to the procedure. RESULTS: The mean left atrial and LAA volumes measured by cardiac CT were 98.9 ± 31.8 and 9.3 ± 3.5 mL, respectively. All patients received successful pulmonary vein isolation and were followed up for 24 months. AF recurrence occurred in 17 patients (33%). LAA volume was significantly greater in patients with AF recurrence than in those without recurrence (11.3 ± 2.9 vs. 8.2 ± 3.4 mL; p = 0.002). Multivariable analysis using Cox regression revealed that LAA volume (hazard ratio 1.32; 95% confidence interval 1.12-1.55; p = 0.001) and persistent AF (hazard ratio 4.22; 95% confidence interval 1.48-12.07; p = 0.007) were independent predictors for AF recurrence. An LAA volume greater than 8.825 mL predicted AF recurrence with 94% sensitivity and 66% specificity. The Kaplan-Meier analysis showed a lower rate free from AF recurrence in the group with an LAA volume >8.825 mL (p < 0.001). CONCLUSIONS: Larger LAA volume was associated with AF recurrence after catheter ablation in patients with paroxysmal and persistent AF.
Entities:
Keywords:
Ablation; Atrial fibrillation; Cardiac computed tomography; Left atrial appendage
Authors: Craig T January; L Samuel Wann; Joseph S Alpert; Hugh Calkins; Joaquin E Cigarroa; Joseph C Cleveland; Jamie B Conti; Patrick T Ellinor; Michael D Ezekowitz; Michael E Field; Katherine T Murray; Ralph L Sacco; William G Stevenson; Patrick J Tchou; Cynthia M Tracy; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2014-03-28 Impact factor: 24.094
Authors: D Katritsis; J P Ioannidis; C E Anagnostopoulos; G E Sarris; E Giazitzoglou; S Korovesis; A J Camm Journal: J Cardiovasc Electrophysiol Date: 2001-07
Authors: Luigi Di Biase; J David Burkhardt; Prasant Mohanty; Javier Sanchez; Sanghamitra Mohanty; Rodney Horton; G Joseph Gallinghouse; Shane M Bailey; Jason D Zagrodzky; Pasquale Santangeli; Steven Hao; Richard Hongo; Salwa Beheiry; Sakis Themistoclakis; Aldo Bonso; Antonio Rossillo; Andrea Corrado; Antonio Raviele; Amin Al-Ahmad; Paul Wang; Jennifer E Cummings; Robert A Schweikert; Gemma Pelargonio; Antonio Dello Russo; Michela Casella; Pietro Santarelli; William R Lewis; Andrea Natale Journal: Circulation Date: 2010-07-06 Impact factor: 29.690
Authors: Adam S Helms; J Jason West; Amit Patel; Michael J Lipinski; J Michael Mangrum; J Paul Mounsey; John P Dimarco; John D Ferguson Journal: Am J Cardiol Date: 2009-04-01 Impact factor: 2.778
Authors: Judit Simon; Mohammed El Mahdiui; Jeff M Smit; Lili Száraz; Alexander R van Rosendael; Szilvia Herczeg; Emese Zsarnóczay; Anikó Ilona Nagy; Márton Kolossváry; Bálint Szilveszter; Nándor Szegedi; Klaudia Vivien Nagy; Tamás Tahin; László Gellér; Rob J van der Geest; Jeroen J Bax; Pál Maurovich-Horvat; Béla Merkely Journal: Clin Cardiol Date: 2021-11-19 Impact factor: 2.882
Authors: Rita B Gagyi; Nándor Szegedi; Judit Simon; Sip Wijchers; Rohit Bhagwandien; Melissa H Kong; Peter Ruppersberg; Tamas Szili-Torok Journal: Front Cardiovasc Med Date: 2022-09-28