Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation

Hong Euy Lim, Jin Oh Na, Sung Il Im, Cheol Ung Choi, Seong Hwan Kim, Jin Won Kim, Eung Ju Kim, Seong Woo Han, Seung-Woon Rha, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Chun Hwang

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Abstract

Background/Aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = –0.537, p <0.001), total left atrium emptying fraction (LAEFtotal;r = –0.213, p = 0.030), and active LAEF (LAEFactive; r = –0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

Original languageEnglish
Pages (from-to)808-820
Number of pages13
JournalKorean Journal of Internal Medicine
Volume30
Issue number6
DOIs
Publication statusPublished - 2015 Nov 1

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Heart Atria
Atrial Fibrillation
Cardiac Arrhythmias
Recurrence
Catheter Ablation
Echocardiography
Multivariate Analysis
Population

Keywords

  • Atrial fibrillation
  • Atrial remodeling
  • Atrial septum
  • Heart atria

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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title = "Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation",
abstract = "Background/Aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = –0.537, p <0.001), total left atrium emptying fraction (LAEFtotal;r = –0.213, p = 0.030), and active LAEF (LAEFactive; r = –0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1{\%}; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.",
keywords = "Atrial fibrillation, Atrial remodeling, Atrial septum, Heart atria",
author = "Lim, {Hong Euy} and Na, {Jin Oh} and Im, {Sung Il} and Choi, {Cheol Ung} and Kim, {Seong Hwan} and Kim, {Jin Won} and Kim, {Eung Ju} and Han, {Seong Woo} and Seung-Woon Rha and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Chun Hwang",
year = "2015",
month = "11",
day = "1",
doi = "10.3904/kjim.2015.30.6.808",
language = "English",
volume = "30",
pages = "808--820",
journal = "Korean Journal of Internal Medicine",
issn = "0494-4712",
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TY - JOUR

T1 - Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation

AU - Lim, Hong Euy

AU - Na, Jin Oh

AU - Im, Sung Il

AU - Choi, Cheol Ung

AU - Kim, Seong Hwan

AU - Kim, Jin Won

AU - Kim, Eung Ju

AU - Han, Seong Woo

AU - Rha, Seung-Woon

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Hwang, Chun

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background/Aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = –0.537, p <0.001), total left atrium emptying fraction (LAEFtotal;r = –0.213, p = 0.030), and active LAEF (LAEFactive; r = –0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

AB - Background/Aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = –0.537, p <0.001), total left atrium emptying fraction (LAEFtotal;r = –0.213, p = 0.030), and active LAEF (LAEFactive; r = –0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

KW - Atrial fibrillation

KW - Atrial remodeling

KW - Atrial septum

KW - Heart atria

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