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Updated: Nov 29, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Large left atrial appendage predicts the ablation outcome in hypertensive patients with atrial fibrillation
1Department of Cardiology, Mianyang Central Hospital, People's Republic of China.
Insights
Left atrial appendage (LAA) volume predicts atrial fibrillation (AF) recurrence after catheter ablation in hypertensive patients. Larger LAA volume, measured by cardiac CT, indicates a higher risk of AF recurrence post-ablation.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Atrial fibrillation (AF) recurrence after catheter ablation is common.
- Predictors of AF recurrence are crucial for patient management.
- Hypertension is a significant comorbidity affecting AF outcomes.
Purpose of the Study:
- To investigate if left atrial appendage (LAA) volume predicts AF recurrence post-catheter ablation in hypertensive patients.
- To assess the role of cardiac computed tomography (CT) in evaluating LAA volume for predicting AF recurrence.
- To identify LAA volume thresholds for predicting AF recurrence.
Main Methods:
- Retrospective evaluation of 108 hypertensive patients with AF undergoing first catheter ablation.
- Contrast-enhanced cardiac CT for LAA and left atrium (LA) anatomy assessment prior to ablation.
- 12-month follow-up to determine AF recurrence rates and clinical outcomes.
Main Results:
- AF recurrence was observed in 22.2% of patients after 12 months.
- Patients with AF recurrence had significantly larger LAA volume, LAA orifice dimensions, LA volume, and higher NT-proBNP levels.
- LAA volume independently predicted post-ablation AF recurrence, with a volume > 9.99 ml showing 83.3% sensitivity and 66.7% specificity.
Conclusions:
- Left atrial appendage (LAA) volume, measured by cardiac CT, is an independent predictor of AF recurrence after catheter ablation in hypertensive individuals.
- LAA volume assessment can aid in risk stratification for AF recurrence post-ablation.
- Cardiac CT-derived LAA volume offers valuable prognostic information for hypertensive patients undergoing AF ablation.
Objective:
Clinical outcomes of patients with atrial fibrillation (AF) undergoing catheter ablation can be influenced by many factors. This study sought to investigate whether left atrial appendage (LAA) volume can predict the recurrence of AF after catheter ablation in hypertensive patients.
Methods:
108 hypertensive patients(aged 63.1 ± 8.1 years, 53.7% male) with paroxysmal or persistent AF undergoing a first catheter ablation were retrospectively evaluated. Contrast-enhanced cardiac computed tomography (CT) was performed in all enrolled patients prior to ablation for assessment of LAA volume and left atrium (LA) anatomy. Patients were followed up for 12 months to analyze the clinical outcomes after AF catheter ablation.
Results:
24 patients had AF recurrence after a mean follow-up of 12 months. Patients with AF recurrence (24, 22.2%) exhibited significantly larger (longer) LAA volume, LAA orifice area, LAA orifice short axis, LA volume, LA diameter and higher level of N-terminal proB-type natriuretic peptide (NT-proBNP) compared to those without AF recurrence. LAA volume correlated with type of AF, LA volume, LA diameter and the level of NT-proBNP. Multiple regression analysis demonstrated that LAA volume was an independent predictor of post-ablation AF recurrence in hypertensive patients. Furthermore, LAA volume > 9.99 ml served as a valuable independent predictor of AF recurrence, with a sensitivity of 83.3% and a specificity of 66.7% (area under the curve = 0.733).
Conclusions:
LAA volume derived from cardiac CT was an independent predictor of AF recurrence after catheter ablation in hypertensive patients.
