Relationship between the time point of left atrial size change and the outcomes of radiofrequency catheter ablation.

PURPOSE: The change in the left atrial anteroposterior diameter (LAD) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has become an independent factor in predicting the postoperative curative effect; however, whether the specific time point of this change is related to the postoperative curative effect is unclear. The purpose of this study was to explore the correlation between the specific time point of LAD change and the recurrence of AF 1 year after RFCA. METHODS: Patients with AF who underwent RFCA in our hospital from July 2016 to May 2020 were enrolled in the study. The patients were divided into four groups according to the time point when the LAD decreased by 10% after RFCA: group A, first month after RFCA; group B, second month after RFCA; group C, third month after RFCA; group D, unchanged or changed > 3 months after RFCA. RESULTS: In the multivariable Cox analyses, the duration of AF, LAD, and persistent AF were independent risk factors for the recurrence of AF. The recurrence rate of AF 1 year after RFCA were significantly lower in groups A (odds ratio [OR], 0.160; 95% confidence interval [CI]: 0.073-0.352; P < 0.001) and C (OR, 0.388; 95% CI: 0.156-0.963; P = 0.041) than in the control group. CONCLUSIONS: Reduction of LAD within 3 months after operation predicts the success rate of RFCA, with reduction within 1 month after operation having a higher success rate. This indicates the necessity of treatment in patients with AF who do not experience an early reduction in the LAD after RFCA.