Right Atrial Anatomical Remodeling Affects Early Outcomes of Nonvalvular Atrial Fibrillation After Radiofrequency Ablation

Abstract

Background: The impact of the right atrial (RA) anatomical remodeling on outcomes of atrial fibrillation (AF) after radiofrequency ablation (RFA) is unclear. Methods and Results: Sixty-three patients (50 men, 57 +/- 10 years, 23 persistent AF [PeAF]) who underwent RFA for AF were enrolled. Both RA and left atrial (LA) volumes, measured with multidetector computed tomography, as well as echocardiographic parameters were compared between subjects with early (< 3 months, n=13) or 1-year (n=19) recurrence after RFA and without recurrence. The RA volume index (RAVI) was larger (98 +/- 21 vs. 77 +/- 22 ml/m(2)) and PeAF was more common (62% vs. 30%) in the early recurrence group (P < 0.05 for all), whereas the LA volume index (LAVI) was similar between the 2 groups (78 +/- 15 vs. 72 +/- 19 ml/m(2), P=0.23). Notably, RAVI was the only independent predictor of early recurrence (for each 10 ml/m(2) increase, OR: 1.650, 95%CI: 1.017-2.677, P=0.04). PeAF was the only independent predictor of 1-year recurrence after RFA (OR: 4.496, 95%CI: 1.110-18.211, P=0.04), whereas RAVI and LAVI were not. Conclusions: RA anatomical remodeling might affect the early recurrence of AF after RFA. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence of AF after RFA. (Circ J 2012; 76: 860-867)