Right atrial anatomical remodeling affects early outcomes of nonvalvular atrial fibrillation after radiofrequency ablation.

ABSTRACT

BACKGROUND: The impact of the right atrial (RA) anatomical remodeling on outcomes of atrial fibrillation (AF) after radiofrequency ablation (RFA) is unclear. METHODS AND RESULTS: Sixty-three patients (50 men, 57±10 years, 23 persistent AF [PeAF]) who underwent RFA for AF were enrolled. Both RA and left atrial (LA) volumes, measured with multidetector computed tomography, as well as echocardiographic parameters were compared between subjects with early (<3 months, n=13) or 1-year (n=19) recurrence after RFA and without recurrence. The RA volume index (RAVI) was larger (98±21 vs. 77±22 ml/m²) and PeAF was more common (62% vs. 30%) in the early recurrence group (P<0.05 for all), whereas the LA volume index (LAVI) was similar between the 2 groups (78±15 vs. 72±19 ml/m², P=0.23). Notably, RAVI was the only independent predictor of early recurrence (for each 10 ml/m² increase, OR 1.650, 95%CI 1.017-2.677, P=0.04). PeAF was the only independent predictor of 1-year recurrence after RFA (OR 4.496, 95%CI 1.110-18.211, P=0.04), whereas RAVI and LAVI were not. CONCLUSIONS: RA anatomical remodeling might affect the early recurrence of AF after RFA. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence of AF after RFA.