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Updated: Nov 18, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
A novel predictive model for late recurrence after catheter ablation for atrial fibrillation using left appendage
Do Young Kim1,2, Yun Gi Kim1, Jong-Il Choi3
1Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Seoul, Republic of Korea.
Insights
Left atrial appendage (LAA) volume independently predicts late recurrence after atrial fibrillation (AF) radiofrequency catheter ablation (RFCA). A new score including LAA volume improves risk stratification for AF recurrence after RFCA.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Larger left atrial appendage (LAA) volume is linked to increased late recurrence (LR) risk post-atrial fibrillation (AF) radiofrequency catheter ablation (RFCA).
- The independent predictive value of LAA volume for LR, beyond established risk factors, remains unclear.
Purpose of the Study:
- To assess the predictive capability of LAA volume for LR after RFCA in AF patients.
- To develop and validate a predictive score incorporating LAA volume for LR risk stratification.
Main Methods:
- Retrospective analysis of 992 patients undergoing RFCA for AF with pre-procedural cardiac CT.
- Multivariate Cox regression identified independent predictors of LR at 3-year follow-up.
- Development of an integrated score model using identified risk factors, including LAA volume index.
Main Results:
- 36.5% of patients experienced LR at 3 years post-RFCA.
- Independent predictors of LR included age ≥75 years, non-paroxysmal AF, diabetes mellitus, left atrial volume index, and LAA volume index tertiles.
- The integrated score model demonstrated good discrimination power with a C-index of 0.715.
Conclusions:
- Left atrial appendage volume is an independent predictor of late recurrence after RFCA for AF.
- The developed predictive model, incorporating LAA volume, shows significant potential for risk stratification in AF recurrence.
- Findings support the integration of LAA volume into risk assessment protocols for patients undergoing RFCA for AF.
Abstract:
Larger left atrial appendage (LAA) volume is associated with a higher risk of late recurrence (LR) in patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, it is unclear whether LAA volume predicts LR, independent of established risk factors. We sought to evaluate the value of LAA volume in predicting LR after RFCA for AF and to develop a score prediction model including LAA volume for these patients. We retrospectively studied 992 patients who underwent RFCA for AF and cardiac computed tomography before RFCA at a single center. At 3 years after RFCA, 362 patients (36.5 %) experienced recurrence. The multivariate Cox regression model showed that age ≥ 75 years (10 points), non-paroxysmal AF (9 points), diabetes mellitus (4 points), left atrial volume index (1 point per 10 ml/m2 rounded to the nearest integer), and the second (4.7 to < 7 ml/m2; 4 points) and third (≥ 7 ml/m2; 5 points) tertiles of the LAA volume index were independent risk factors LR. The above-mentioned risk factors were included in the integrated score model, and the C-index of the proposed score model was 0.715 (95 % confidence interval [CI] 0.679-0.752). LAA volume is an independent predictor of LR and the predictive model including LAA volume showed good discrimination power. These findings provide evidence for the inclusion of LAA volume in the risk stratification for AF recurrence in patients undergoing RFCA for AF.
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