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Title: | Combined Area of Left and Right Atria May Outperform Atrial Volumes as a Predictor of Recurrences after Ablation in Patients with Persistent Atrial Fibrillation—A Pilot Study |
Author: | Margulescu, Andrei D Mas Lladó, Caterina Prat González, Susanna Perea Palazón, Rosario Jesús Borras, Roger Benito-Ramal, Eloy Alarcón, Francisco Guasch i Casany, Eduard Tolosana, José M. (José María) Arbelo, Elena Sitges Carreño, Marta Brugada Terradellas, Josep, 1958- Mont Girbau, Lluís |
Keywords: | Malalties del cor Fibril·lació auricular Arrítmia Cateterisme cardíac Ressonància magnètica Heart diseases Atrial fibrillation Arrhythmia Cardiac catheterization Magnetic resonance |
Issue Date: | 1-Jan-2024 |
Publisher: | MDPI |
Abstract: | Background and Objectives: Left atrial (LA) remodelling and dilatation predicts atrial fibrillation (AF) recurrences after catheter ablation. However, whether right atrial (RA) remodelling and dilatation predicts AF recurrences after ablation has not been fully evaluated. Materials and Methods: This is an observational study of 85 consecutive patients (aged 57 ± 9 years; 70 [82%] men) who underwent cardiac magnetic resonance before first catheter ablation for AF (40 [47.1%] persistent AF). Four-chamber cine-sequence was selected to measure LA and RA area, and ventricular end-systolic image phase to obtain atrial 3D volumes. The effect of different variables on event-free survival was investigated using the Cox proportional hazards model. Results: In patients with persistent AF, combined LA and RA area indexed to body surface area (AILA + RA) predicted AF recurrences (HR = 1.08, 95% CI 1.00-1.17, p = 0.048). An AILA + RA cut-off value of 26.7 cm2/m2 had 72% sensitivity and 73% specificity for predicting recurrences in patients with persistent AF. In this group, 65% of patients with AILA + RA > 26.7 cm2/m2 experienced AF recurrence within 2 years of follow-up (median follow-up 11 months), compared to 25% of patients with AILA + RA ≤ 26.7 cm2/m2 (HR 4.28, 95% CI 1.50-12.22; p = 0.007). Indices of LA and RA dilatation did not predict AF recurrences in patients with paroxysmal AF. Atrial 3D volumes did not predict AF recurrences after ablation. Conclusions: In this pilot study, the simple measurement of AILA + RA may predict recurrences after ablation of persistent AF, and may outperform measurements of atrial volumes. In paroxysmal AF, atrial dilatation did not predict recurrences. Further studies on the role of RA and LA remodelling are needed. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/medicina60010151 |
It is part of: | Medicina (Kaunas), 2024, vol. 60, num.1 |
URI: | http://hdl.handle.net/2445/210041 |
Related resource: | https://doi.org/10.3390/medicina60010151 |
ISSN: | 1010-660X |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Medicina) |
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