A CT-derived left atrial volume ≥117 cc strongly predicted atrial fibrillation recurrence at 1 year following radiofrequency catheter ablation (OR 4.8; 95% CI 1.4-16.4; P=0.01).
Cohort (n=88)
Does left atrial size measured by CT, TEE, and TTE predict recurrence of atrial fibrillation following radiofrequency catheter ablation in patients with paroxysmal or persistent AF?
Left atrial volume measured by CT is a strong, independent predictor of atrial fibrillation recurrence at 1 year following radiofrequency catheter ablation, offering predictive benefit over standard echocardiographic diameters.
Effect estimate: OR 4.8 (95% CI 1.4-16.4)
p-value: p=0.01
BACKGROUND: Recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA) has been well established and is in part related to left atrial (LA) size. The purpose of this study was to assess the predictive capability of LA diameter (LAD) and LA volume (LAV) by echocardiography and computed tomography (CT) to determine success in patients undergoing RFCA of AF. METHODS: Eighty-eight patients with paroxysmal or persistent AF who had undergone RFCA and had a prior transthoracic echocardiogram (TTE), transesophageal echocardiogram (TEE), and CT were enrolled in the study. TTE LADs and LV ejection fraction as well as TEE LADs and LAVs in three views were recorded. CT LAVs were also recorded. Clinical parameters prior to ablation as well as at 1-year follow-up were assessed. RESULTS: A total of 40 (45%) patients with paroxysmal AF and 48 (55%) patients with persistent AF were analyzed. Paroxysmal AF patients had a RFCA success rate of 88% at 1 year with persistent AF patients having a 52% success rate (P or= 117 cc was associated with an odds ratio (OR) for recurrence of 4.8 (95% confidence interval CI=1.4-16.4, P = 0.01) while a LAV >or=130 cc was associated with an OR for recurrence of 22.0 (95% CI =2.5-191.0, P = 0.005) after adjustment for persistent AF. CONCLUSIONS: LA dimensions and AF type are highly predictive of AF recurrence following RFCA. LAV by CT has significant predictive benefit over standard LADs in severely enlarged atria even after adjustment for AF type.
Parikh et al. (Mon,) conducted a cohort in Paroxysmal or persistent atrial fibrillation (n=88). CT-derived left atrial volume ≥117 cc vs. CT-derived left atrial volume <117 cc was evaluated on Recurrence of atrial fibrillation (OR 4.8, 95% CI 1.4-16.4, p=0.01). A CT-derived left atrial volume ≥117 cc strongly predicted atrial fibrillation recurrence at 1 year following radiofrequency catheter ablation (OR 4.8; 95% CI 1.4-16.4; P=0.01).