Open AccessLeft atrial diameter in estimating success rates of radio-frequency ablation treating atrial fibrillation.
Author(s) -
M.D. MOHAMED ABDELMOTTAAL TAWAB MOHAMED T. ELSAYEGH,
Mohamad Ali El Ghannam,
Ayman Ammar,
Ali Taha,
Ahmed Bahig El Kerdany
Publication year - 2019
Publication title -
the egyptian cardiothoracic surgeon
Language(s) - English
Resource type - Journals
eISSN - 2636-3291
pISSN - 2636-3151
DOI - 10.35810/ects.v1i1.23
Subject(s) - atrial fibrillation , medicine , sinus rhythm , cardiology , ablation , mitral valve , prospective cohort study , receiver operating characteristic , ablation of atrial fibrillation , p wave , catheter ablation , mitral regurgitation , surgery
Background: Ablation devices are being utilized in surgical procedures treating atrial fibrillation. Few studies seek to define a cut-off value for left atrial diameter size beyond which risks of procedure outweigh chance of sinus recovery. This study aims to identify a cut-off value for pre-operative left atrial diameter to assess the efficacy of surgical radio-frequency ablation for treatment of chronic atrial fibrillation in patients undergoing mitral valve surgery. Methods: A prospective 6-month follow-up cohort study was done, in which 40 patients were recruited during the period from May 2016 till April 2018. All patients had rheumatic mitral valve disease and permanent atrial fibrillation. Receiver operator characteristic (ROC) curves were used to calculate the area under the curve and cut-off value for left atrial diameter. The efficacy of the overall survival time was estimated using the Kaplan‐Meier method. Results: Pre-operatively left atrial diameter of 59 mm was significantly associated with decrease in the possibility of reverting to sinus rhythm after surgery (OR 0.292, p-value = 0.001). The cut-off value for left atrial diameter was 59mm (sensitivity = 93.3%, specificity = 96.1%). Kaplan-Meier survival estimates were 175.07 days (156.3 - 193.9) for patients with left atrial diameter 59mm. Conclusion: In patients undergoing mitral valve, higher degrees of success are associated with smaller left atrial diameter in terms of conservation of the sinus rhythm post operatively.