The Right to Left Atrial Volume Ratio Predicts Outcomes after Circumferential Pulmonary Vein Isolation of Longstanding Persistent Atrial Fibrillation.
Pacing Clin Electrophysiol
; 39(11): 1181-1190, 2016 Nov.
Article
en En
| MEDLINE
| ID: mdl-27641059
ABSTRACT
BACKGROUND:
We aimed to identify the predictors of clinical outcomes after circumferential pulmonary vein isolation (CPVI) without any substrate modification for longstanding persistent atrial fibrillation (LSP-AF).METHODS:
This study retrospectively analyzed 70 consecutive LSP-AF patients who underwent an initial CPVI and were followed-up for more than 1 year. The right and left atrial volumes indexed to the body surface areas (right atrial volume index [RAVI] and left atrial volume index [LAVI]) were determined by preacquired contrast-enhanced computed tomography (CT). The %RAVI/LAVI was obtained as 100 × RAVI/LAVI.RESULTS:
During a median follow-up period of 15 months (interquartile range, 13-19 months), 21 patients (30%) had arrhythmia recurrences after the CPVI. Antiarrhythmic drugs were continued in 34 patients (48%). In the Cox proportional hazard model, the %RAVI/LAVI was a significant positive predictor of arrhythmia recurrences (hazard ratio, 1.048; P = 0.039). A receiver-operating characteristic analysis demonstrated that at an optimal cutoff of 100.1 for the %RAVI/LAVI, the sensitivity and specificity for predicting arrhythmia recurrences were 85.7% and 71.4%, respectively. The Kaplan-Meier analysis showed that arrhythmia recurrences were less frequent in patients with a %RAVI/LAVI of <100.1 than in those with a %RAVI/LAVI of ≥100.1 (P < 0.0001), and the arrhythmia-free survival rate at 12 months was 89.7% and 45.2%, respectively.CONCLUSIONS:
The ratio of the RAVI to LAVI on CT may be a useful predictor of clinical outcomes after CPVI of LSP-AF. LSP-AF patients with a less predominant right atrial enlargement relative to the left atrial enlargement may be good candidates for successful treatment with CPVI alone as the ablation strategy for LSP-AF.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Venas Pulmonares
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Fibrilación Atrial
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Volumen Cardíaco
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón