Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation: Three-dimensional imaging study using multidetector computed tomography

Jeonggeun Moon, Hye Jeong Lee, Jaemin Shim, Jae Sun Uhm, Jong Youn Kim, Hui Nam Pak, Moon Hyoung Lee, Young Jin Kim, Boyoung Joung

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear. Methods Patients who underwent RFA of AF (n = 242, 197 men, 57 ± 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]). Three-dimensional RA and LA volumes were measured before RFA with multidetector computed tomography and indexed to body surface area (RAVI and LAVI). Results After a 3-month blanking period, 66 patients (27%) failed to maintain sinus rhythm during follow-up (556 ± 322 days). Despite similar clinical characteristics, LAVI was larger (77 ± 21 vs. 91 ± 27 ml/m2, P < 0.001) and RAVI showed a trend to be greater (85 ± 26 vs. 92 ± 25 ml/m2, P = 0.06) in patients with future recurrence than without recurrence. Additionally, patients with larger RA or LA experienced recurrences more frequently and earlier during follow-up (log rank, P < 0.05 for all). In Cox regression analysis, LAVI was independently associated with outcomes (10 ml/m2 increase; HR: 1.22, 95% CI: 1.09-1.36, P < 0.001), whereas RAVI was not. In subgroup analysis, 25 PaAF patients (16%) experienced recurrence and both atrial volumes failed to predict the outcome independently, despite borderline significance of RAVI (10 ml/m2 increase; HR: 1.21, 95% CI: 1.00-1.48, P = 0.05). Meanwhile, 41 patients (49%) in PeAF group experienced AF recurrence and LAVI was an independent prognosticator (10 ml/m2 increase; HR: 1.19, 95% CI: 1.03-1.36). Conclusions RA size might affect the outcome after RFA in PaAF patients. LA enlargement, rather than RA size, influence outcomes after RFA, especially in PeAF.

Original languageEnglish
Pages (from-to)5430-5436
Number of pages7
JournalInternational Journal of Cardiology
Volume168
Issue number6
DOIs
Publication statusPublished - 2013 Oct 15
Externally publishedYes

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Three-Dimensional Imaging
Multidetector Computed Tomography
Atrial Fibrillation
Recurrence
Body Surface Area
Regression Analysis

Keywords

  • Ablation
  • Atrial fibrillation
  • Left atrium
  • Prognosis
  • Right atrium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation : Three-dimensional imaging study using multidetector computed tomography. / Moon, Jeonggeun; Lee, Hye Jeong; Shim, Jaemin; Uhm, Jae Sun; Kim, Jong Youn; Pak, Hui Nam; Lee, Moon Hyoung; Kim, Young Jin; Joung, Boyoung.

In: International Journal of Cardiology, Vol. 168, No. 6, 15.10.2013, p. 5430-5436.

Research output: Contribution to journalArticle

Moon, Jeonggeun ; Lee, Hye Jeong ; Shim, Jaemin ; Uhm, Jae Sun ; Kim, Jong Youn ; Pak, Hui Nam ; Lee, Moon Hyoung ; Kim, Young Jin ; Joung, Boyoung. / Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation : Three-dimensional imaging study using multidetector computed tomography. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 6. pp. 5430-5436.
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abstract = "Background Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear. Methods Patients who underwent RFA of AF (n = 242, 197 men, 57 ± 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]). Three-dimensional RA and LA volumes were measured before RFA with multidetector computed tomography and indexed to body surface area (RAVI and LAVI). Results After a 3-month blanking period, 66 patients (27{\%}) failed to maintain sinus rhythm during follow-up (556 ± 322 days). Despite similar clinical characteristics, LAVI was larger (77 ± 21 vs. 91 ± 27 ml/m2, P < 0.001) and RAVI showed a trend to be greater (85 ± 26 vs. 92 ± 25 ml/m2, P = 0.06) in patients with future recurrence than without recurrence. Additionally, patients with larger RA or LA experienced recurrences more frequently and earlier during follow-up (log rank, P < 0.05 for all). In Cox regression analysis, LAVI was independently associated with outcomes (10 ml/m2 increase; HR: 1.22, 95{\%} CI: 1.09-1.36, P < 0.001), whereas RAVI was not. In subgroup analysis, 25 PaAF patients (16{\%}) experienced recurrence and both atrial volumes failed to predict the outcome independently, despite borderline significance of RAVI (10 ml/m2 increase; HR: 1.21, 95{\%} CI: 1.00-1.48, P = 0.05). Meanwhile, 41 patients (49{\%}) in PeAF group experienced AF recurrence and LAVI was an independent prognosticator (10 ml/m2 increase; HR: 1.19, 95{\%} CI: 1.03-1.36). Conclusions RA size might affect the outcome after RFA in PaAF patients. LA enlargement, rather than RA size, influence outcomes after RFA, especially in PeAF.",
keywords = "Ablation, Atrial fibrillation, Left atrium, Prognosis, Right atrium",
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T1 - Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation

T2 - Three-dimensional imaging study using multidetector computed tomography

AU - Moon, Jeonggeun

AU - Lee, Hye Jeong

AU - Shim, Jaemin

AU - Uhm, Jae Sun

AU - Kim, Jong Youn

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Kim, Young Jin

AU - Joung, Boyoung

PY - 2013/10/15

Y1 - 2013/10/15

N2 - Background Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear. Methods Patients who underwent RFA of AF (n = 242, 197 men, 57 ± 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]). Three-dimensional RA and LA volumes were measured before RFA with multidetector computed tomography and indexed to body surface area (RAVI and LAVI). Results After a 3-month blanking period, 66 patients (27%) failed to maintain sinus rhythm during follow-up (556 ± 322 days). Despite similar clinical characteristics, LAVI was larger (77 ± 21 vs. 91 ± 27 ml/m2, P < 0.001) and RAVI showed a trend to be greater (85 ± 26 vs. 92 ± 25 ml/m2, P = 0.06) in patients with future recurrence than without recurrence. Additionally, patients with larger RA or LA experienced recurrences more frequently and earlier during follow-up (log rank, P < 0.05 for all). In Cox regression analysis, LAVI was independently associated with outcomes (10 ml/m2 increase; HR: 1.22, 95% CI: 1.09-1.36, P < 0.001), whereas RAVI was not. In subgroup analysis, 25 PaAF patients (16%) experienced recurrence and both atrial volumes failed to predict the outcome independently, despite borderline significance of RAVI (10 ml/m2 increase; HR: 1.21, 95% CI: 1.00-1.48, P = 0.05). Meanwhile, 41 patients (49%) in PeAF group experienced AF recurrence and LAVI was an independent prognosticator (10 ml/m2 increase; HR: 1.19, 95% CI: 1.03-1.36). Conclusions RA size might affect the outcome after RFA in PaAF patients. LA enlargement, rather than RA size, influence outcomes after RFA, especially in PeAF.

AB - Background Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear. Methods Patients who underwent RFA of AF (n = 242, 197 men, 57 ± 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]). Three-dimensional RA and LA volumes were measured before RFA with multidetector computed tomography and indexed to body surface area (RAVI and LAVI). Results After a 3-month blanking period, 66 patients (27%) failed to maintain sinus rhythm during follow-up (556 ± 322 days). Despite similar clinical characteristics, LAVI was larger (77 ± 21 vs. 91 ± 27 ml/m2, P < 0.001) and RAVI showed a trend to be greater (85 ± 26 vs. 92 ± 25 ml/m2, P = 0.06) in patients with future recurrence than without recurrence. Additionally, patients with larger RA or LA experienced recurrences more frequently and earlier during follow-up (log rank, P < 0.05 for all). In Cox regression analysis, LAVI was independently associated with outcomes (10 ml/m2 increase; HR: 1.22, 95% CI: 1.09-1.36, P < 0.001), whereas RAVI was not. In subgroup analysis, 25 PaAF patients (16%) experienced recurrence and both atrial volumes failed to predict the outcome independently, despite borderline significance of RAVI (10 ml/m2 increase; HR: 1.21, 95% CI: 1.00-1.48, P = 0.05). Meanwhile, 41 patients (49%) in PeAF group experienced AF recurrence and LAVI was an independent prognosticator (10 ml/m2 increase; HR: 1.19, 95% CI: 1.03-1.36). Conclusions RA size might affect the outcome after RFA in PaAF patients. LA enlargement, rather than RA size, influence outcomes after RFA, especially in PeAF.

KW - Ablation

KW - Atrial fibrillation

KW - Left atrium

KW - Prognosis

KW - Right atrium

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