Journal
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Volume 24, Issue 7, Pages 752-759Publisher
WILEY-BLACKWELL
DOI: 10.1111/jce.12116
Keywords
atrial fibrillation; catheter ablation; remodeling; cardiac magnetic resonance; left atrial sphericity
Categories
Funding
- Ministerio de Ciencia e Innovacion, Instituto de Salud Carlos III, Madrid, Spain [PI1102003, RD06/0003/008, RD06/0009]
- Hospital Clinic, Barcelona, Spain
- St. Jude Medical (Ensite NaVx)
- Biosense Webster (CARTO)
Ask authors/readers for more resources
Left Atrial Sphericity Predicts AF Ablation Outcome Background Atrial fibrillation (AF) ablation outcome is mainly determined by atrial remodeling that, nowadays, is only estimated through clinical presentation (persistent vs. paroxysmal) and left atrial (LA) dimension. The aim of the study was to stage the atrial remodeling process using the Left Atrial Sphericity (LASP) and determine whether this technique may help to predict AF ablation outcome. Methods Consecutive patients who underwent contrast-enhanced cardiac magnetic resonance angiography before AF ablation were included in the study. Three-dimensional reconstruction of LA excluding pulmonary veins and the LA appendage was used to define the LA cavity. The LASP was automatically obtained with self-customized software. Results 106 patients were included and categorized in 3 groups (Gs): discoid-LA (G1), intermediate-LA (G2), and spherical-LA (G3). The G3 patients had larger LA anteroposterior diameter than G1 and G2 patients (47 +/- 7 vs 43 +/- 6 and 39 +/- 5mm; P < 0.001), greater LA volume (90 +/- 39 vs 86 +/- 24 and 73 +/- 20 mm; P = 0.012), and higher prevalence of persistent AF (75% vs 48% and 29%; P = 0.034) structural heart disease (75% vs 19% and 19%; P < 0.001), and AF recurrence at 12 months follow-up (58% vs 29% and 5%, P < 0.001). The LASP had linear correlation to predicted probability of recurrence. Multivariate analysis identified LASP (OR 1.320 [1.096-1.591], P = 0.004) and hypertension (OR 3.694 [1.282-10.645]; P = 0.016) as independent risk factors for arrhythmia recurrence. Conclusion Left Atrial Sphericity is a new independent predictor of recurrence after AF ablation and may be useful in selecting the best candidates for AF ablation.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available