A novel predictive model for late recurrence after catheter ablation for atrial fibrillation using left appendage volume measured by cardiac computed tomography

Do Young Kim, Yun Gi Kim, Jong Il Choi, Ha Young Choi, Yun Young Choi, Ki Yung Boo, Kwang No Lee, Seung Young Rho, Jaemin Shim, Jin-Seok Kim, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Larger left atrial appendage (LAA) volume is associated with a higher risk of late recurrence (LR) in patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, it is unclear whether LAA volume predicts LR, independent of established risk factors. We sought to evaluate the value of LAA volume in predicting LR after RFCA for AF and to develop a score prediction model including LAA volume for these patients.We retrospectively studied 992 patients who underwent RFCA for AF and cardiac computed tomography before RFCA at a single center.At 3 years after RFCA, 362 patients (36.5 %) experienced recurrence. The multivariate Cox regression model showed that age ≥ 75 years (10 points), non-paroxysmal AF (9 points), diabetes mellitus (4 points), left atrial volume index (1 point per 10 ml/m2 rounded to the nearest integer), and the second (4.7 to < 7 ml/m2; 4 points) and third (≥ 7 ml/m2; 5 points) tertiles of the LAA volume index were independent risk factors LR. The above-mentioned risk factors were included in the integrated score model, and the C-index of the proposed score model was 0.715 (95 % confidence interval [CI] 0.679–0.752).LAA volume is an independent predictor of LR and the predictive model including LAA volume showed good discrimination power. These findings provide evidence for the inclusion of LAA volume in the risk stratification for AF recurrence in patients undergoing RFCA for AF.

Original languageEnglish
Pages (from-to)2063-2070
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume37
Issue number6
DOIs
Publication statusPublished - 2021 Jun

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Computed tomography
  • Left atrial appendage
  • Volume

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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