| Association Between Left and Right Atrial Remodeling with Atrial Fibrillation Recurrence Following Pulmonary Vein Catheter Ablation in Patients with Paroxysmal Atrial Fibrillation: A Pilot Study. | |
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MedLine Citation:
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PMID: 21778328 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: -Left atrial (LA) remodeling is a factor in atrial fibrillation (AF) recurrence after pulmonary vein catheter ablation (CA), but right atrium (RA) remodeling has not been investigated for possible associations to AF recurrence. METHODS AND RESULTS: -Using sixty-four slice multi-detector computed tomography, RA and LA volumes were measured three-dimensionally before CA in 65 patients with initially proven idiopathic paroxysmal AF (mean age: 60 ± 10 years, 81.5% male). The CA procedure was guided by CARTO Merge Atrial Electroanatomical Mapping. Sixteen patients (24.6%) had AF recurrence within the 6-month period following the CA. The recurrence was associated with a large RA volume [odds ratio 1.04, 95% Confidence Interval (CI) 1.02-1.07, p<0.0001], a large LA volume with 1.04 [95%CI 1.01-1.06, p=0.002], and low LA mean voltage with 1.03 [95% CI 1.01-1.05, p=0.002]. After adjustment for potential confounding variables, RA and LA volume remained predictive of AF recurrence. Large atrial volumes (mL) (RA>87 or LA>99) predicted AF recurrence (sensitivity of RA volume: 81.3% in 13 of 16 patients with AF recurrence, specificity: 75.5% in 37 of 49 patients without AF recurrence; sensitivity of LA volume: 81.3% in 13 of 16 patients with AF recurrence, specificity: 69.4% in 34 of 49 patients without AF recurrence), and the combined estimate of both atrial volumes was incremental and additive prognostic power (sensitivity: 75% in 12 of 16 patients with AF recurrence, specificity: 93.9% in 46 of 49 patients without AF recurrence). CONCLUSIONS: -Both LA and RA remodeling are equally associated with post-CA AF recurrence. |
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Authors:
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Yasushi Akutsu; Kyouichi Kaneko; Yusuke Kodama; Jumpei Suyama; Hui-Ling Li; Yuji Hamazaki; Kaoru Tanno; Takehiko Gokan; Youichi Kobayashi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-21 |
Journal Detail:
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Title: Circulation. Cardiovascular imaging Volume: - ISSN: 1942-0080 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Showa University School of Medicine, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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