Left atrial expansion index and hypertension predicted arrhythmia elimination after a first RFCA (54% success), while age and LA maximum volume predicted success after repeated RFCA (40% success).
Observational (n=154)
Does three-dimensional echocardiography assessment of left atrial size and function predict arrhythmia recurrence in patients with atrial fibrillation undergoing radiofrequency catheter ablation?
3D echocardiography-derived left atrial function and size, combined with clinical factors, can predict the success of both first and repeated radiofrequency catheter ablation for atrial fibrillation.
Absolute Event Rate: 54% vs 40%
AIMS: Left atrial (LA) size has been related to the success of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, potential predictors after a repeated procedure are unknown. We evaluate predictive factors related to successful AF ablation after a first and a repeated RFCA. METHODS AND RESULTS: A total of 154 patients with AF were treated with RFCA. LA size and function were assessed with three-dimensional echocardiography (3D Echo) before RFCA. The effectiveness of RFCA was evaluated after 6 months. Recurrence of the arrhythmia was defined as any documented (clinically or by 24-h Holter recording) atrial tachyarrhythmia lasting >30 s after 12 weeks following RFCA. Of 154 patients, 103 (67%) underwent a first ablation (Group 1) and 51 (33%) a repeated RFCA (Group 2). At follow-up, arrhythmias were eliminated in 56 of 103 (54%) patients after a first RFCA and in 20 of 51 (40%) after a repeated ablation. In Group I, hypertension and LA expansion index derived from 3D Echo were independent predictors of arrhythmia elimination. In Group 2, only age predicted persistence of sinus rhythm; and only in younger patients (≤54 year old), though 3D LA maximal volumes were significantly smaller in those without when compared with those with AF recurrences. CONCLUSION: A combination of the analysis of LA function with 3D Echo and clinical data predicts elimination of AF after a first ablation procedure for AF, beyond LA size. Among patients undergoing a repeated procedure, age and 3D echocardiographic LA maximum volume in younger patients predict the success of RFCA.
Montserrat et al. (Tue,) conducted a observational in Atrial fibrillation (n=154). First radiofrequency catheter ablation (RFCA) vs. Repeated RFCA was evaluated on Arrhythmia recurrence (documented atrial tachyarrhythmia >30 s after 12 weeks). Left atrial expansion index and hypertension predicted arrhythmia elimination after a first RFCA (54% success), while age and LA maximum volume predicted success after repeated RFCA (40% success).