Key result
Two-stage model with 3-year LAD remodeling outperforms baseline models in predicting AF recurrence after RFCA.
Why the study?
The long-term prognostic influence of left atrial diameter remodeling on post-radiofrequency catheter ablation atrial fibrillation outcome is unclear.
Does a two-stage model incorporating longitudinal left atrial diameter remodeling predict atrial fibrillation ablation outcomes better than baseline left atrial diameter?
Observational
Does a two-stage model incorporating longitudinal left atrial diameter remodeling predict atrial fibrillation ablation outcomes better than baseline left atrial diameter?
A longitudinal two-stage model incorporating left atrial diameter remodeling over 3 years outperforms baseline left atrial diameter in predicting atrial fibrillation recurrence after radiofrequency catheter ablation.
May improve post-ablation AF recurrence prediction via longitudinal LA remodeling; hypothesis-generating, needs validation before practice change.
BACKGROUND: The long-term prognostic influence of left atrial diameter (LAD) remodeling on the status of post-radiofrequency catheter ablation (RFCA) atrial fibrillation (AF) is unclear. This study employed a two-stage model from 3-year echocardiographic data to ascertain whether the two-stage model predicts RFCA outcome more favorably than models using the baseline LAD. METHODS: stage), and observed 3-year LAD (Model 3) were constructed to predict RFCA outcome. The area under the receiver operating characteristic curve (AUC) were used to assess the performance of models. RESULTS: The lowess smoothed curve indicated that the LAD declined over the first three months and remained stable up to 36 months after RFCA. The degree of LAD reduction was significantly influenced by the baseline LAD. Non-paroxysmal AF, large LAD and female gender were significant predictors of AF recurrence. Model 2 had the largest AUC among the three models. CONCLUSIONS: This longitudinal study-based two-stage model outperforms the original logistic model using the baseline LAD. Non-paroxysmal AF, larger LAD and female gender are significant predictors of RFCA failure.
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Lee et al. (2018) conducted an observational in Atrial fibrillation. Left atrial diameter (LAD) remodeling vs. Baseline LAD was evaluated on Radiofrequency catheter ablation outcome (atrial fibrillation recurrence). A two-stage model incorporating 3-year left atrial diameter remodeling outperformed baseline models in predicting atrial fibrillation recurrence after radiofrequency catheter ablation.
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