Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation: Three-dimensional imaging study using multidetector computed tomography
- Authors
- Moon, Jeonggeun; Lee, Hye-Jeong; Shim, Jaemin; Uhm, Jae-Sun; Kim, Jong-Youn; Pak, Hui-Nam; Lee, Moon-Hyoung; Kim, Young Jin; Joung, Boyoung
- Issue Date
- 15-Oct-2013
- Publisher
- ELSEVIER IRELAND LTD
- Keywords
- Right atrium; Left atrium; Atrial fibrillation; Ablation; Prognosis
- Citation
- INTERNATIONAL JOURNAL OF CARDIOLOGY, v.168, no.6, pp.5430 - 5436
- Journal Title
- INTERNATIONAL JOURNAL OF CARDIOLOGY
- Volume
- 168
- Number
- 6
- Start Page
- 5430
- End Page
- 5436
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14215
- DOI
- 10.1016/j.ijcard.2013.08.045
- ISSN
- 0167-5273
- Abstract
- Background: Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear. Methods: Patients who underwent RFA of AF (n = 242, 197 men, 57 +/- 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]). Three-dimensional RA and LA volumes were measured before RFA with multidetector computed tomography and indexed to body surface area (RAVI and LAVI). Results: After a 3-month blanking period, 66 patients (27%) failed to maintain sinus rhythm during follow-up (556 +/- 322 days). Despite similar clinical characteristics, LAVI was larger (77 +/- 21 vs. 91 +/- 27 ml/m(2), P < 0.001) and RAVI showed a trend to be greater (85 +/- 26 vs. 92 +/- 25 ml/m(2), P = 0.06) in patients with future recurrence than without recurrence. Additionally, patients with larger RA or LA experienced recurrences more frequently and earlier during follow-up (log rank, P < 0.05 for all). In Cox regression analysis, LAVI was independently associated with outcomes (10 ml/m(2) increase; HR: 1.22, 95% CI: 1.09-1.36, P < 0.001), whereas RAVI was not. In subgroup analysis, 25 PaAF patients (16%) experienced recurrence and both atrial volumes failed to predict the outcome independently, despite borderline significance of RAVI (10 ml/m(2) increase; HR: 1.21, 95% CI: 1.00-1.48, P = 0.05). Meanwhile, 41 patients (49%) in PeAF group experienced AF recurrence and LAVI was an independent prognosticator (10 ml/m(2) increase; HR: 1.19, 95% CI: 1.03-1.36). Conclusions: RA size might affect the outcome after RFA in PaAF patients. LA enlargement, rather than RA size, influence outcomes after RFA, especially in PeAF. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - 의과대학 > 의학과 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14215)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.