Key result
A total pulmonary vein volume greater than 12.0 cm3/BSA(m2) predicted a higher probability of atrial fibrillation recurrence after radiofrequency catheter ablation in paroxysmal atrial fibrillation.
Why the study?
Does pulmonary vein volume quantified by MDCT predict atrial fibrillation recurrence after radiofrequency catheter ablation in patients with symptomatic atrial fibrillation?
Observational (n=118)
No
Does pulmonary vein volume quantified by MDCT predict atrial fibrillation recurrence after radiofrequency catheter ablation in patients with symptomatic atrial fibrillation?
Effect estimate: AUC 0.682 (95% CI 0.541-0.822)
p-value: p=0.013
Total pulmonary vein volume quantified by MDCT is an independent predictor of atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation.
Pulmonary vein volume may refine pre-ablation recurrence risk estimates in paroxysmal AF; hypothesis-generating and requires prospective validation.
PURPOSE: Catheter ablation of atrial fibrillation (AF) is an effective therapy for selected groups of patients. We evaluated whether quantification of left atrium (LA) or pulmonary vein (PV) by using multi-detector computed tomography (MDCT) may predict the success rate of PV isolation procedure. METHODS: We included 118 patients younger than 65 years with symptomatic AF (73 paroxysmal, PAF; 45 non-paroxysmal, non-PAF). All patients underwent 256-slice MDCT prior to circumferential PV isolation to evaluate anatomy, volume and dimensions of LA and PV. RESULTS: After a mean follow-up of 14 months, complete success was achieved in 50 patients (68.5%) of PAF and in 26 patients (57.8%) of non-PAF. In the PAF group, total PV volume was found to be an independent predictor of AF recurrence, whereas LA volume was not. Logistic regression analysis showed that the probability of AF recurrence was higher in patients with total PV volume greater than 12.0 cm3/BSA (m2) (AUC 0.682, 95%CI 0.541-0.822). In the non-PAF group, no independent risk factor of LA or PV size was observed for the postoperative recurrence. CONCLUSIONS: The PV volume quantification may predict the success of AF ablation in PAF patients.
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Shimamoto et al. (2018) conducted an observational in Symptomatic atrial fibrillation (n=118). Radiofrequency catheter ablation (RFCA) was evaluated on Atrial fibrillation recurrence (AUC 0.682, 95% CI 0.541-0.822, p=0.013). A total pulmonary vein volume greater than 12.0 cm3/BSA(m2) predicted a higher probability of atrial fibrillation recurrence after radiofrequency catheter ablation in paroxysmal atrial fibrillation.
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