RESUMO
Aims: Left atrial (LA) diameter is a predictor of atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFA). However, LA volume (LAV) is more accurate in assessing LA size. Studies evaluating LAV as a predictor of AF recurrence are contradictory; therefore, we performed a meta-analysis to assess whether LAV is an independent predictor of AF recurrence following RFA. Methods and results: All studies reporting LAV/LAV index (LAVi) as a predictor of AF recurrence following RFA were included. For studies reporting mean LAV/ LAVi in patients with and without AF recurrence, standard difference in means (SDM) and standard errors were calculated, and combined using meta-analytical techniques. For studies reporting adjusted odds ratio (OR) for AF recurrence based on LAV/LAVi, log ORs were combined using generic inverse variance. Twenty one studies (3822 subjects) were included. Meta-analysis of 11 studies (1559 subjects) reporting LAV, showed that patients with AF recurrence had a higher mean LA volume compared to patients with no recurrence (SDM 0.801; CI 0.387-1.216). Data from 9 studies (1425 subjects) comparing LAVi showed that, patients with AF recurrence had a higher mean LAVi compared to patients with no recurrence (SDM-0.596; CI 0.305-0.888). Thirteen studies (2886 patients) reporting ORs for AF recurrence based on LAV/ LAVi, showed that LAV/LAVi was independently predictive of AF recurrence post-RFA (OR-1.032, CI- 1.012-1.052). Conclusions: Patients with AF recurrence following RFA have a higher mean LAV/LAVi compared to patients with no recurrence. Large LAV/LAVi increases the odds of AF recurrence post RFA.
Assuntos
Fibrilação Atrial/cirurgia , Função do Átrio Esquerdo , Remodelamento Atrial , Ablação por Cateter/efeitos adversos , Átrios do Coração/cirurgia , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/fisiopatologia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Observacionais como Assunto , Razão de Chances , Modelos de Riscos Proporcionais , Recidiva , Medição de Risco , Fatores de Risco , Resultado do TratamentoRESUMO
Coarctation of the aorta, virtually always a congenital malformation, is characterized by localized aortic narrowing, usually in the arch opposite to the ductus arteriosus and just distal to the left subclavian artery. The condition occasionally goes undiagnosed until adulthood. We report a case of a 55-year-old man who presented with uncontrolled hypertension, pulmonary edema, and non-ST-segment elevation myocardial infarction due to multi-vessel coronary artery disease. He underwent successful simultaneous coronary artery bypass grafting and coarctation repair using an ascending-to-descending aortic bypass graft.