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Left atrium remodeling predicts late recurrence of paroxysmal atrial fibrillation after second generation cryoballoon ablation.
- Source :
-
Cardiovascular ultrasound [Cardiovasc Ultrasound] 2018 Sep 25; Vol. 16 (1), pp. 19. Date of Electronic Publication: 2018 Sep 25. - Publication Year :
- 2018
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Abstract
- Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Nowadays, AF ablation is a valuable treatment option. It has been shown that the left atrium (LA) diameter is a predictor of AF recurrence after cryoballoon ablation (CBA). Since it does not reflect the true LA size, we compared the role of different LA anatomical parameters using echocardiography for the prediction of AF recurrence after CBA.<br />Methods: We retrospectively included 209 patients (mean age 56.1 ± 13.6 years, male 62%) with paroxysmal AF undergoing CBA. A transthoracic echocardiography was performed in all patients.<br />Results: At a mean follow-up of 16.9 ± 6.3 months, AF recurred in 25.4% of the patients. LA anterior - posterior diameter (LAD), LA minimum volume (LAmin) and early AF recurrence were independent predictors of recurrence. Based on receiver operating characteristics, cut - off values for LAD and, LAmin were 41 mm, 23.69 mL, respectively. The negative predictive values for recurrence were 73% and 87.3% respectively. In patients with AF recurrence, a significant proportion (30.2%) showed LA longitudinal remodeling (LA superior - inferior diameter) even though classically measured LAD was normal.<br />Conclusions: Longitudinal LA remodeling plays an additional role for predicting AF recurrence after CBA, in patients without LAD dilation. Moreover, LAmin had a high negative predictive value and was an independent predictor of AF recurrence. Therefore, a more complete LA anatomical assessment allows a better prediction of AF recurrences after CBA.
- Subjects :
- Atrial Fibrillation physiopathology
Atrial Fibrillation surgery
Equipment Design
Female
Heart Atria physiopathology
Humans
Male
Middle Aged
Prognosis
ROC Curve
Recurrence
Retrospective Studies
Tachycardia, Paroxysmal physiopathology
Tachycardia, Paroxysmal surgery
Treatment Outcome
Atrial Fibrillation diagnosis
Atrial Remodeling
Catheter Ablation instrumentation
Echocardiography methods
Heart Atria diagnostic imaging
Tachycardia, Paroxysmal diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1476-7120
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular ultrasound
- Publication Type :
- Academic Journal
- Accession number :
- 30249263
- Full Text :
- https://doi.org/10.1186/s12947-018-0137-8