TY - JOUR
T1 - Left atrium remodeling predicts late recurrence of paroxysmal atrial fibrillation after second generation cryoballoon ablation
AU - Motoc, Andreea
AU - Abugattas, Juan-Pablo
AU - Roosens, Bram
AU - Scheirlynck, Esther
AU - Heyndrickx, Benedicte
AU - de Asmundis, Carlo
AU - Chierchia, Gian-Battista
AU - Droogmans, Steven
AU - Cosyns, Bernard
PY - 2018/9/25
Y1 - 2018/9/25
N2 - 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.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.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.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.
AB - 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.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.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.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.
KW - Atrial Fibrillation/diagnosis
KW - Atrial Remodeling
KW - Catheter Ablation/instrumentation
KW - Echocardiography/methods
KW - Equipment Design
KW - Female
KW - Heart Atria/diagnostic imaging
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - ROC Curve
KW - Recurrence
KW - Retrospective Studies
KW - Tachycardia, Paroxysmal/diagnosis
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85053785312&partnerID=8YFLogxK
U2 - 10.1186/s12947-018-0137-8
DO - 10.1186/s12947-018-0137-8
M3 - Article
C2 - 30249263
VL - 16
SP - 19
EP - 19
JO - Cardiovascular Ultrasound
JF - Cardiovascular Ultrasound
SN - 1476-7120
IS - 1
M1 - 19
ER -