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Computed Tomography-Derived Left Atrial Volume Index, Gender, and Age to Predict the Presence and the Extent of Left Atrial Low Voltage Zones in Patients with Atrial Fibrillation: the ZAQ Score
- Publication Year :
- 2020
-
Abstract
- BACKGROUND Pulmonary vein isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). However, with advanced left atrial (LA) structural changes, additional targeted catheter ablation of low-voltage zones (LVZs) has produced favorable results. Therefore, with the advent of single-shot techniques, it would be helpful to predict the presence of LVZs before an ablation procedure. OBJECTIVE We hypothesized that computed tomography (CT)-derived left atrial volume index (LAVI), in combination with other objective parameters, could be used to develop a score able to predict the presence of LVZs. METHODS In a large cohort of patients undergoing their first AF ablations, comprehensive echocardiographic evaluations and cardiac CT were performed. During the electrophysiological studies, LA geometry and electroanatomic voltage maps were created. LVZs were defined as areas ≥1 cm2 with bipolar peak-to-peak voltage amplitudes ≤0.5 mV. RESULTS In a derivation cohort of 374 patients, predictors of LVZs were identified by regression analysis and used to build the Zentralklinik Bad Berka and University of L'Aquila (ZAQ) score (age ≥65 years; female sex; and CT-LAVI ≥57 mL/m2 ). The ZAQ score of 2 points accurately identified the presence and the extent of LVZs (area under the curve [AUC], 0.809; 95% confidence interval [CI], 0.758-0.861; P
- Subjects :
- Ablation Techniques
Male
medicine.medical_specialty
medicine.medical_treatment
Clinical Decision-Making
Action Potentials
Catheter ablation
030204 cardiovascular system & hematology
risk score
Risk Assessment
ablation
Pulmonary vein
03 medical and health sciences
Sex Factors
0302 clinical medicine
Heart Rate
Predictive Value of Tests
Risk Factors
Interquartile range
Physiology (medical)
Internal medicine
Multidetector Computed Tomography
medicine
Humans
atrial fibrillation
Heart Atria
Prospective Studies
030212 general & internal medicine
pulmonary vein isolation
Aged
Body surface area
Framingham Risk Score
business.industry
body surface area
Age Factors
Area under the curve
Reproducibility of Results
Atrial fibrillation
Atrial Remodeling
Middle Aged
medicine.disease
Confidence interval
Cardiology
Atrial Function, Left
Female
Electrophysiologic Techniques, Cardiac
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....b542e4b70b3bcbac7f6f7709d612973d