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The prognostic role of right atrial (RA) is unclear. We evaluated the prognostic implication of each atrial anatomical remodeling after the radiofrequency ablation (RFA) of atrial fibrillation (AF).
Total 234 patients (189 men, 57±11 years) including 154 paroxysmal (PaAF) and 80 persistent AF (PeAF), who underwent the RFA, were enrolled. Right and left atrial (LA) volume index (RAVI and LAVI, respectiveley) were measured with 64-slice multidetector computed tomography before RFA.
After a 3-month blanking period, 1-year recurrence without antiarrhythmic drugs were documented in 92 (39%) patients, who were older and had larger LAVI (73±18 vs. 93±26 ml/m2) and RAVI (80±20 vs. 97±31 ml/m2) (P<0.05 for all). Patients with AF recurrence had larger LAVI and RAVI in both PaAF and PeAF. In multivariate analysis, RAVI was the only independent predictor of AF recurrence in PaAF (odds ratio [OR]: 1.26, 95% confidence interval [CI]: 1.03-1.53, P=0.03). The RAVI >83 ml/m2 predicted AF recurrence in PaAF with a sensitivity of 62% and a specificity of 65%. Meanwhile, LAVI (OR: 1.62, 95% CI: 1.05-2.51, P=0.03), along with age (OR: 1.04, 95% CI: 1.01-1.14, P=0.02), was associated with recurrent AF in PeAF, whereas RAVI was not. The LAVI>86 ml/m2 predicted AF recurrence in PeAF with a sensitivity of 83% and a specificity of 71%.
RA volume might affect the outcome in PaAF patients after RFA. However, LA size was more closely related than RA volume with 1-year recurrence of AF after RFA in PeAF.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: AF/SVT VII
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1236-36
- 2013 American College of Cardiology Foundation