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Prognostic Value of Left Atrial Calcification After Catheter Ablation for Atrial Fibrillation

Daisuke Yakabe1, Kisho Ohtani1, Yusuke Fukuyama2

  • 1Department of Cardiovascular Medicine, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan; Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

JACC. Clinical Electrophysiology
|February 8, 2023
PubMed

Insights

Left atrial calcification (LAC) is linked to increased cardiovascular risks after atrial fibrillation (AF) ablation. This finding highlights LAC as a key prognostic factor for adverse events in AF patients undergoing ablation.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Left atrial calcification (LAC) is observed in patients with atrial fibrillation (AF) undergoing catheter ablation.
  • Limited evidence exists on the clinical impact of LAC in AF patients.

Purpose of the Study:

  • To determine the prevalence of LAC in AF patients.
  • To evaluate the clinical significance of LAC after AF ablation.

Main Methods:

  • Observational registry of AF patients who underwent computed tomography (CT) and echocardiography.
  • Primary composite outcome: cardiovascular death, heart failure hospitalization, ischemic stroke.
  • Follow-up duration: median 5.8 years.

Main Results:

  • LAC was present in 5.8% of 534 AF patients; 13.8% of 218 patients who underwent AF ablation.
  • AF ablation was associated with an 11.8-fold increased risk of LAC development.
  • Prior stroke and multiple ablation procedures independently predicted LAC development.
  • LAC presence independently predicted major adverse cardiovascular events (adjusted HR: 2.81; P=0.02).

Conclusions:

  • Left atrial calcification is a significant prognostic factor for adverse cardiovascular events post-AF ablation.
  • LAC presence indicates a higher risk of major adverse cardiovascular events.
Abstract

Keywords:
atrial fibrillationcatheter ablationleft atrial calcificationleft atrial remodelingstiff left atrial physiology

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