An LAD/LAAEV ratio ≥1.42 predicted higher recurrence of atrial fibrillation with a hazard ratio of 1.36, sensitivity 70.4%, and specificity 87.5%.
Does the intraprocedural ICE-measured LAD/LAAEV ratio predict the risk of recurrence of atrial fibrillation after radiofrequency catheter ablation?
The intraprocedural ICE-measured LAD/LAAEV ratio is an independent predictor of AF recurrence at 1 year post-ablation, offering a novel metric for risk stratification.
Absolute Event Rate: 0% vs 0%
BACKGROUND AND OBJECTIVES: This study evaluated the ability of intraprocedural intracardiac echocardiography (ICE)-measured left atrial appendage (LAA) flow characteristics to predict the long-term risk of recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation. METHODS: The study included 105 patients who underwent radiofrequency catheter ablation for AF at our institution between October 2020 and December 2021. Eighty-seven of these patients completed 12 months of follow-up. The anteroposterior left atrial diameter to LAA emptying velocity (LAD/LAAEV) ratio was calculated. The patients were stratified into a recurrence group (n=18) and a non-recurrence group (n=69) based on the 12-month outcome. Predictive performance was evaluated by Cox regression and by receiver-operating characteristic curve and Kaplan-Meier survival analyses. RESULTS: The LAD/LAAEV ratio (P<0.001) was significantly higher in the recurrence group than in the non-recurrence group. Multivariate Cox analysis identified the LAD/LAAEV ratio (hazard ratio 1.36, 95 % confidence interval CI 1.02-1.83) and New York Heart Association functional class (hazard ratio 2.75, 95 % CI 1.19-6.35) as independent predictors of recurrence by one year. Receiver-operating characteristic curve analysis confirmed that the LAD/LAAEV ratio predicted recurrence with an area under the curve of 0.806 (95 % CI 0.707-0.906); the optimal cutoff was 1.42 (sensitivity 70.4 %, specificity 87.5 %). Kaplan-Meier analysis showed that the cumulative recurrence rate was significantly higher in the group with an LAD/LAAEV ratio of ≥1.42 (P<0.001, log-rank test). CONCLUSIONS: The ICE-measured LAD/LAAEV ratio may predict recurrence of AF post-ablation, providing a basis for intensified post-procedural management in high-risk patients.
Cui et al. (Mon,) reported a other. An LAD/LAAEV ratio ≥1.42 predicted higher recurrence of atrial fibrillation with a hazard ratio of 1.36, sensitivity 70.4%, and specificity 87.5%.