Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation?

Irene Hof, Karuna Chilukuri, Armin Arbab-Zadeh, Daniel Scherr, Darshan Dalal, Saman Nazarian, Charles Henrikson, David Spragg, Ronald Berger, Joseph Marine, Hugh Calkins

    Research output: Contribution to journalArticlepeer-review

    136 Scopus citations

    Abstract

    Does LA Volume and PV Anatomy Predict the Outcome of Catheter Ablation of AF. Introduction: Preprocedural factors may be helpful in selecting patients with atrial fibrillation (AF) for treatment with catheter ablation and in making an assumption regarding their prognosis. The aims of this study were to investigate whether left atrial (LA) volume and pulmonary venous (PV) anatomy, evaluated by computed tomography (CT) prior to ablation, will predict AF recurrence following catheter ablation. Methods and Results: We included 146 patients (mean age 57 ± 11 years, 83% male) with symptomatic AF (55% paroxysmal, 18% persistent, 27% long-standing persistent). All patients underwent CT scanning prior to catheter ablation to evaluate LA volume and PV anatomy. Circumferential PV isolation was performed guided by Cartomerge electroanatomical mapping. The outcome was defined as complete success, improvement, or failure. After a mean follow-up of 19 ±7 months, complete success was achieved in 59 patients (40%), and 38 patients (26%) demonstrated improvement. LA volume was found to be an independent predictor of AF recurrence with an adjusted OR of 1.14 for every 10-mL increase in volume (95% CI 1.00-1.29, P = 0.047). PV variations were equally distributed among the different outcomes of the ablation procedure, and therefore univariate analysis did not identify PV anatomy as a predictor of outcome. Conclusion: LA volume is an independent predictor of AF recurrence after catheter ablation. Additionally, PV anatomy did not have any effect on the outcome. These findings suggest that an assessment of LA volume may be incorporated into the preprocedural evaluation of patients being considered for AF ablation. (J Cardiovasc Electrophysiol, Vol. 20, pp. 1005-1010)

    Original languageEnglish (US)
    Pages (from-to)1005-1010
    Number of pages6
    JournalJournal of cardiovascular electrophysiology
    Volume20
    Issue number9
    DOIs
    StatePublished - Sep 1 2009

    Keywords

    • Atrial fibrillation
    • Catheter ablation
    • Computed tomography
    • Left atrium
    • Pulmonary veins
    • Recurrence

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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