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- Title
Left atrial size and function by three-dimensional echocardiography to predict arrhythmia recurrence after first and repeated ablation of atrial fibrillation.
- Authors
Montserrat, Sílvia; Gabrielli, Luigi; Borras, Roger; Poyatos, Sílvia; Berruezo, Antonio; Bijnens, Bart; Brugada, Josep; Mont, Lluis; Sitges, Marta
- Abstract
Aims Left atrial (LA) size has been related to the success of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, potential predictors after a repeated procedure are unknown. We evaluate predictive factors related to successful AF ablation after a first and a repeated RFCA. Methods and results A total of 154 patients with AF were treated with RFCA. LA size and function were assessed with three-dimensional echocardiography (3D Echo) before RFCA. The effectiveness of RFCA was evaluated after 6 months. Recurrence of the arrhythmia was defined as any documented (clinically or by 24-h Holter recording) atrial tachyarrhythmia lasting >30 s after 12 weeks following RFCA. Of 154 patients, 103 (67%) underwent a first ablation (Group 1) and 51 (33%) a repeated RFCA (Group 2). At follow-up, arrhythmias were eliminated in 56 of 103 (54%) patients after a first RFCA and in 20 of 51 (40%) after a repeated ablation. In Group I, hypertension and LA expansion index derived from 3D Echo were independent predictors of arrhythmia elimination. In Group 2, only age predicted persistence of sinus rhythm; and only in younger patients (≤54 year old), though 3D LA maximal volumes were significantly smaller in those without when compared with those with AF recurrences. Conclusion A combination of the analysis of LA function with 3D Echo and clinical data predicts elimination of AF after a first ablation procedure for AF, beyond LA size. Among patients undergoing a repeated procedure, age and 3D echocardiographic LA maximum volume in younger patients predict the success of RFCA.
- Subjects
ARRHYTHMIA diagnosis; ATRIAL fibrillation treatment; HYPERTENSION; CARDIOVASCULAR disease diagnosis; CATHETER ablation; LEFT heart atrium; ADRENERGIC beta blockers; AMIODARONE; ANTICOAGULANTS; ATRIAL fibrillation; BODY weight; CARDIOLOGY; CHI-squared test; CONFIDENCE intervals; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAPHY; EPIDEMIOLOGY; FLECAINIDE; CARDIAC patients; PATIENT aftercare; LONGITUDINAL method; STATURE; OPERATIVE surgery; U-statistics; COMORBIDITY; DISEASE relapse; LOGISTIC regression analysis; DATA analysis; ANATOMY
- Publication
European Heart Journal - Cardiovascular Imaging, 2014, Vol 15, Issue 5, p515
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jet194