Key result
Left atrial volume determined by angiography and CARTO mapping correlated significantly with 3DE volume (r=0.56 and r=0.67, respectively), but both invasive techniques yielded larger values.
Why the study?
Do invasive measurements of left atrial volume (angiography or CARTO mapping) agree with non-invasive real-time 3D echocardiography in patients undergoing ablation for atrial fibrillation?
Observational (n=127)
Do invasive measurements of left atrial volume (angiography or CARTO mapping) agree with non-invasive real-time 3D echocardiography in patients undergoing ablation for atrial fibrillation?
Effect estimate: r = 0.56 for angiography; r = 0.67 for CARTO
p-value: p=< 0.0001
Invasive techniques (angiography and electro-anatomic mapping) yield significantly larger left atrial volumes compared to 3D echocardiography, indicating they cannot be used interchangeably as baseline values for non-invasive follow-up.
LA volumes by angiography/CARTO and 3DE are not interchangeable for follow-up; leaves open validation of modality-specific references in AF ablation cohorts.
AIMS: Left atrial (LA) volume can be determined during radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) with angiography or electro-anatomic (CARTO) mapping. We compared these volumes with LA volume measured using transthoracic real-time three-dimensional echocardiography (3DE). METHODS AND RESULTS: One hundred and twenty-seven consecutive patients undergoing RFCA for AF were studied using biplane pulmonary vein angiography with opacification of the LA. LA volume was calculated from the diameter measurements with a formula using an ellipsoid model. A subset of 22 patients also underwent LA volume determination by CARTO mapping. These volumes were then correlated with LA volume determined non-invasively by real-time 3DE. Linear regression showed a significant correlation between LA volume determined by angiography and 3DE volume (r = 0.56, P < 0.0001). Bland-Altman analysis showed a bias of 38 +/- 22 ml by the angiographic method. LA volume measured using CARTO correlated better (r = 0.67, P < 0.001), but 3DE yielded smaller values (mean difference of -30 +/- 19 ml). CONCLUSION: LA volume determination by angiography and CARTO mapping correlate significantly with 3DE volume. However, both invasive techniques yield larger values for LA volume. The results indicate that LA volume obtained by angiography or CARTO should not be used as baseline value for non-invasive follow-up of LA remodelling by 3DE.
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Müller et al. (2010) conducted an observational in Atrial fibrillation (n=127). Angiography and electro-anatomic (CARTO) mapping vs. Real-time three-dimensional echocardiography (3DE) was evaluated on Left atrial volume (r = 0.56 for angiography; r = 0.67 for CARTO, p=< 0.0001). Left atrial volume determined by angiography and CARTO mapping correlated significantly with 3DE volume (r=0.56 and r=0.67, respectively), but both invasive techniques yielded larger values.
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