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Right atrial diameter and outcome of catheter ablation of atrial fibrillation

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机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Beijing Anzhen Rd, Beijing 100029, Peoples R China
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关键词: Atrial fibrillation Catheter ablation Recurrence Left atrium Right atrium

摘要:
While AF is considered more like a left atrial (LA) disease, to what extent the right atrium contributes to the pathogenesis and ablation outcome of AF remains unclear. This study aimed to identify if right atrial diameter (RAD) could predict arrhythmia recurrence after catheter ablation of atrial fibrillation (AF). Four hundred and seventy patients with drug-resistant AF [paroxysmal AF (PAF) 196; non-PAF 274] who underwent primary catheter ablation were enrolled. Ablation strategy included complete bilateral pulmonary vein isolation (PVI) in all patients and additional linear ablation across mitral isthmus, LA roof, and tricuspid isthmus in non-PAF cases. Risk factors associated with recurrence were determined by a Cox regression model, and the predictive power was evaluated by using receiver operating characteristic curve. After 24.3 +/- 18.0 months, 284 patients (60.6%) experienced atrial tachyarrhythmia recurrence (111 in PAF, 173 in non-PAF). RAD was moderately associated with LA diameter (r = 0.371, P < 0.001), left ventricular ejection fraction (r = -0.205, P < 0.001), and left ventricular end-diastolic diameter (r = 0.319, P < 0.001). Multivariate Cox regression analysis demonstrated that RAD was an independent predictor for recurrence only in PAF patients with LAD 35 mm (HR 1.044, 95% CI 1.007-1.082, P = 0.021). The RAD cutoff value of 35.5 mm predicts atrial tachyarrhythmia recurrence with 85.4% sensitivity and 29.2% specificity. Kaplan-Meier analysis indicated that RAD over 35.5 mm is associated with more recurrence after PAF ablation (log-rank P = 0.034), comparing to those with RAD < 35.5 mm. RAD predicts outcome of ablation only in patients with PAF and concurrent LA enlargement. Under this condition, RAD < 35.5 mm is associated with a more favorable recurrence-free survival at over 2-year follow-up.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统
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出版当年[2015]版:
Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Beijing Anzhen Rd, Beijing 100029, Peoples R China
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通讯机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Beijing Anzhen Rd, Beijing 100029, Peoples R China
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