Pre-interventional left atrial ejection fraction assessed by cardiac CT strongly predicted AF recurrence after pulmonary vein isolation (AUC 0.94; 95% CI 0.84-0.99).
Cohort (n=50)
No
Do left atrial and left atrial appendage ejection fractions assessed by prior cardiac CT predict recurrence of atrial fibrillation after pulmonary vein isolation?
Pre-procedural assessment of left atrial and left atrial appendage ejection fraction using cardiac CT provides highly accurate prediction of atrial fibrillation recurrence following pulmonary vein isolation.
Estimación del efecto: AUC 0.94 (95% CI 0.84-0.99)
Tasa de eventos absoluta: 16% vs 36%
valor p: p=0.00002
Assuming that atrial fibrillation (AF) is associated with left atrial remodeling and dysfunction, we hypothesize that left atrial and left atrial appendage ejection fractions (LAEF and LAAEF) are useful and may be more sensitive outcome predictors of pulmonary vein isolation (PVI). Fifty patients who underwent PVI at our institution with available pre-interventional cardiac computed tomography (CT) for procedure planning were included in this retrospective study. The patients were separated into two groups by recurrence and non-recurrence of AF and subgroups of paroxysmal and persistent AF. Semiautomatic volumetric analysis of the left atrium was used to calculate morphological and functional parameters and optimal cut-offs were calculated using the Youden index. LAEF (accuracy 94%, sensitivity 67%) and LAAEF (accuracy 90%, sensitivity 67%) were significantly reduced in patients with AF recurrence (16% vs. 36%, p = 0.00002; 16% vs. 42%, p = 0.000002), and in the subgroup analysis, the functional parameters were independent from AF type (paroxysmal and persistent). With a cut-off of <23% for both LAEF and LAAEF (area under the curve (AUC) 0.94, 95%CI 0.84–0.99 and AUC 0.96, 95%CI 0.86–0.99, respectively), AF recurrence occurred in 77.8%, within a mean follow-up period of 229 days. In conclusion, left atrial function on prior cardiac CT offers useful parameters for predicting AF recurrence after PVI.
Kaufmann et al. (Sat,) conducted a cohort in Atrial Fibrillation (n=50). AF recurrence group vs. Non-recurrence group was evaluated on Left atrial ejection fraction (LAEF) (AUC 0.94, 95% CI 0.84-0.99, p=0.00002). Pre-interventional left atrial ejection fraction assessed by cardiac CT strongly predicted AF recurrence after pulmonary vein isolation (AUC 0.94; 95% CI 0.84-0.99).