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Left Atrial Volume Best Predicts Recurrence after Catheter Ablation in Patients with Persistent and Longstanding Persistent Atrial Fibrillation
Author(s) -
KOHÁRI MÁRIA,
ZADO ERICA,
MARCHLINSKI FRANCIS E.,
CALLANS DAVID J.,
HAN YUCHI
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12279
Subject(s) - medicine , atrial fibrillation , cardiology , pulmonary vein , sinus rhythm , catheter ablation , ablation , odds ratio , confidence interval , logistic regression
Patients with persistent and longstanding persistent atrial fibrillation (AF) have a higher recurrence rate after antral pulmonary vein isolation (PVI). We sought to determine the clinical, invasive, and noninvasive diastolic function parameters that are associated with AF recurrence after ablation in patients with persistent and longstanding persistent nonvalvular AF. Methods and Results We studied 125 consecutive patients with persistent and longstanding persistent AF who underwent antral PVI at our institution between April 2009 and April 2011. Standard clinical parameters, left atrial (LA) pressure measured at transseptal puncture, and standard diastolic function parameters on transthoracic echocardiographic (TTE) parameters were assessed. TTE was performed in sinus rhythm the first day following radiofrequency catheter ablation. Ablation eliminated AF in 83 of 125 (66.4%) patients (mean age 61.3 ± 8.9, 81% male) during 17.8 ± 7.7 months of follow‐up. Using logistic regression analysis, AF duration prior to ablation (P = 0.04, odds ratio [OR]: 1.03, 95% confidence interval [CI] 1.0–1.06) was found to be the only clinical parameter significantly associated with AF recurrence. According to multiple logistic regression analysis, the indexed LA minimum volume of 26 cm 3 /m 2 (P = 0.009, OR: 4.9 95% CI 1.5–16.2) was the only independent imaging parameter associated with AF recurrence. Conclusion Indexed minimal LA volume is highly associated with ablation success in patients with persistent and longstanding persistent AF.