Adjusted left atrial emptying fraction as a predictor of procedural outcome after catheter ablation for atrial fibrillation

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4 Citations (Scopus)

Abstract

Structural remodeling of the left atrium is a risk factor for recurrent arrhythmia after catheter ablation for atrial fibrillation; however, data are sparse regarding the role of functional left atrial remodeling in predicting procedural outcomes. We evaluated whether left atrial transport function could be used to predict recurrent atrial fibrillation. From July 2008 through August 2010, we enrolled 202 consecutive patients who underwent catheter ablation for atrial fibrillation (paroxysmal=120, persistent=82). Left atrial volumes (LAVs) were measured by means of multislice computed tomography at every 10% of the R-R interval, and measurements were adjusted for body surface area to yield the LAV index (LAVI) at baseline. The left atrial emptying fraction (LAEF) was calculated according to LAV differences. During the mean follow-up period of 10 ± 4 months after a single ablation procedure, atrial fibrillation recurred in 59 patients (paroxysmal=19, persistent=40). Multivariate analysis revealed that persistent atrial fibrillation, early mitral inflow velocity, LAVI<inf>max</inf>, LAVI<inf>min</inf>, LAEF, LAVI<inf>max</inf>/LAEF, and LAVI<inf>min</inf>/LAEF were all independent predictors of atrial fibrillation, but the best predictor was LAVI<inf>min</inf>/LAEF (β=1.329, P=0.001). The cutoff value was 1.61 (mL/m<sup>2</sup>)/%, and the sensitivity and specificity were 74.6% and 62.2%, respectively (area under the curve=0.761). Our study shows that adjusted left atrial emptying fraction with use of multislice computed tomography might be a useful, noninvasive method to select patients for ablation.

Original languageEnglish
Pages (from-to)216-225
Number of pages10
JournalTexas Heart Institute Journal
Volume42
Issue number3
DOIs
Publication statusPublished - 2015 Jun 11

Fingerprint

Catheter Ablation
Atrial Fibrillation
Multidetector Computed Tomography
Left Atrial Function
Atrial Remodeling
Body Surface Area
Heart Atria
Area Under Curve
Cardiac Arrhythmias
Multivariate Analysis
Sensitivity and Specificity

Keywords

  • Atrial fibrillation/physiopathology
  • Atrial function
  • Cardiac volume
  • Catheter ablation
  • Heart atria/pathology/ultrasonography
  • Left/physiology
  • Predictive value of tests
  • Preoperative care/methods
  • Recurrence
  • ROC curve
  • Tomography
  • X-ray computed/methods

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{0d2c06cb40404228b7404042322d46e7,
title = "Adjusted left atrial emptying fraction as a predictor of procedural outcome after catheter ablation for atrial fibrillation",
abstract = "Structural remodeling of the left atrium is a risk factor for recurrent arrhythmia after catheter ablation for atrial fibrillation; however, data are sparse regarding the role of functional left atrial remodeling in predicting procedural outcomes. We evaluated whether left atrial transport function could be used to predict recurrent atrial fibrillation. From July 2008 through August 2010, we enrolled 202 consecutive patients who underwent catheter ablation for atrial fibrillation (paroxysmal=120, persistent=82). Left atrial volumes (LAVs) were measured by means of multislice computed tomography at every 10{\%} of the R-R interval, and measurements were adjusted for body surface area to yield the LAV index (LAVI) at baseline. The left atrial emptying fraction (LAEF) was calculated according to LAV differences. During the mean follow-up period of 10 ± 4 months after a single ablation procedure, atrial fibrillation recurred in 59 patients (paroxysmal=19, persistent=40). Multivariate analysis revealed that persistent atrial fibrillation, early mitral inflow velocity, LAVImax, LAVImin, LAEF, LAVImax/LAEF, and LAVImin/LAEF were all independent predictors of atrial fibrillation, but the best predictor was LAVImin/LAEF (β=1.329, P=0.001). The cutoff value was 1.61 (mL/m2)/{\%}, and the sensitivity and specificity were 74.6{\%} and 62.2{\%}, respectively (area under the curve=0.761). Our study shows that adjusted left atrial emptying fraction with use of multislice computed tomography might be a useful, noninvasive method to select patients for ablation.",
keywords = "Atrial fibrillation/physiopathology, Atrial function, Cardiac volume, Catheter ablation, Heart atria/pathology/ultrasonography, Left/physiology, Predictive value of tests, Preoperative care/methods, Recurrence, ROC curve, Tomography, X-ray computed/methods",
author = "Im, {Sung Il} and Na, {Jin Oh} and Kim, {Sun Won} and Choi, {Cheol Ung} and Kim, {Jin Won} and Hwan-Seok Yong and Kim, {Eung Ju} and Seung-Woon Rha and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Lim, {Hong Euy}",
year = "2015",
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day = "11",
doi = "10.14503/THIJ-14-4524",
language = "English",
volume = "42",
pages = "216--225",
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TY - JOUR

T1 - Adjusted left atrial emptying fraction as a predictor of procedural outcome after catheter ablation for atrial fibrillation

AU - Im, Sung Il

AU - Na, Jin Oh

AU - Kim, Sun Won

AU - Choi, Cheol Ung

AU - Kim, Jin Won

AU - Yong, Hwan-Seok

AU - Kim, Eung Ju

AU - Rha, Seung-Woon

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Lim, Hong Euy

PY - 2015/6/11

Y1 - 2015/6/11

N2 - Structural remodeling of the left atrium is a risk factor for recurrent arrhythmia after catheter ablation for atrial fibrillation; however, data are sparse regarding the role of functional left atrial remodeling in predicting procedural outcomes. We evaluated whether left atrial transport function could be used to predict recurrent atrial fibrillation. From July 2008 through August 2010, we enrolled 202 consecutive patients who underwent catheter ablation for atrial fibrillation (paroxysmal=120, persistent=82). Left atrial volumes (LAVs) were measured by means of multislice computed tomography at every 10% of the R-R interval, and measurements were adjusted for body surface area to yield the LAV index (LAVI) at baseline. The left atrial emptying fraction (LAEF) was calculated according to LAV differences. During the mean follow-up period of 10 ± 4 months after a single ablation procedure, atrial fibrillation recurred in 59 patients (paroxysmal=19, persistent=40). Multivariate analysis revealed that persistent atrial fibrillation, early mitral inflow velocity, LAVImax, LAVImin, LAEF, LAVImax/LAEF, and LAVImin/LAEF were all independent predictors of atrial fibrillation, but the best predictor was LAVImin/LAEF (β=1.329, P=0.001). The cutoff value was 1.61 (mL/m2)/%, and the sensitivity and specificity were 74.6% and 62.2%, respectively (area under the curve=0.761). Our study shows that adjusted left atrial emptying fraction with use of multislice computed tomography might be a useful, noninvasive method to select patients for ablation.

AB - Structural remodeling of the left atrium is a risk factor for recurrent arrhythmia after catheter ablation for atrial fibrillation; however, data are sparse regarding the role of functional left atrial remodeling in predicting procedural outcomes. We evaluated whether left atrial transport function could be used to predict recurrent atrial fibrillation. From July 2008 through August 2010, we enrolled 202 consecutive patients who underwent catheter ablation for atrial fibrillation (paroxysmal=120, persistent=82). Left atrial volumes (LAVs) were measured by means of multislice computed tomography at every 10% of the R-R interval, and measurements were adjusted for body surface area to yield the LAV index (LAVI) at baseline. The left atrial emptying fraction (LAEF) was calculated according to LAV differences. During the mean follow-up period of 10 ± 4 months after a single ablation procedure, atrial fibrillation recurred in 59 patients (paroxysmal=19, persistent=40). Multivariate analysis revealed that persistent atrial fibrillation, early mitral inflow velocity, LAVImax, LAVImin, LAEF, LAVImax/LAEF, and LAVImin/LAEF were all independent predictors of atrial fibrillation, but the best predictor was LAVImin/LAEF (β=1.329, P=0.001). The cutoff value was 1.61 (mL/m2)/%, and the sensitivity and specificity were 74.6% and 62.2%, respectively (area under the curve=0.761). Our study shows that adjusted left atrial emptying fraction with use of multislice computed tomography might be a useful, noninvasive method to select patients for ablation.

KW - Atrial fibrillation/physiopathology

KW - Atrial function

KW - Cardiac volume

KW - Catheter ablation

KW - Heart atria/pathology/ultrasonography

KW - Left/physiology

KW - Predictive value of tests

KW - Preoperative care/methods

KW - Recurrence

KW - ROC curve

KW - Tomography

KW - X-ray computed/methods

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U2 - 10.14503/THIJ-14-4524

DO - 10.14503/THIJ-14-4524

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AN - SCOPUS:84931830403

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JO - Texas Heart Institute Journal

JF - Texas Heart Institute Journal

SN - 0730-2347

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