Remodeling Disparity between Left Atrium and Appendage Relates to Recurrence after Atrial Fibrillation Ablation

Jongil Choi, Yae Min Park, Ji Eun Ban, Kyoung Jeong Ko, Joo Yong Seong, Boo Kyoung Han, Soon Hwa Shin, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

Abstract

Hypothesis: Different alterations of volume between left atrium (LA) and appendage (LAA) can predict clinical outcome of ablation of atrial fibrillation (AF). Methods: Among 386 consecutive patients (37% non-paroxysmal AF), 284 patients with LAD<45mm and 102 with LAD>45mm were assessed. LA diameter (LAD) was measured by transthoracic echocardiography, and volumes of LA and LAA were calculated by 3-D CT scan. Results: During mean 22±16 months, rate of freedom from recurrence was higher in LAD<45mm compared with LAD>45mm (80.3% vs 61.8%, p<0.001). In patients with LAD<45mm, LAD and LAA volume were significantly greater in patients with recurrence compared with those without recurrence (40.1 ± 3.9 vs 37.8±4.4mm, p<0.001; 12.8±12.2 vs 9.3±4.0ml, p=0.042), whereas there was no significant difference in LA volume. In patients with LAD>45mm, LAA volume was significantly larger in patients with recurrence than those without recurrence (15.5±8.9 vs 11.8±5.6ml, p=0.024), however, there was no difference in LAD and LA volume. In patients with LAD<45;mm, LAD was associated with higher recurrence rate (OR 1.127; 95%CI 1.031-1.232; p=0.008), whereas in patients with LAD>45mm, LAA volume independently predicted recurrence after AF ablation (OR 1.094; 95%CI 1.003-1.194; p=0.044). Conclusions: Larger LAA volume predicts recurrence after ablation of AF in patients with enlarged LA. These finding suggests that LAA is an important substrate of AF in remodeled LA.

Original languageEnglish
Number of pages1
JournalJournal of Arrhythmia
Volume27
Issue number4
DOIs
Publication statusPublished - 2011 Jan 1

Keywords

  • atrial fibrillation
  • left atrial appendage
  • remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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