Left Atrium Volume Measured with Multislice Computed Tomography as a Prognostic Predictor for Atrial Fibrillation...

Area of Science:

• Cardiology
• Medical Imaging
• Electrophysiology

Background:

• Current guidelines recommend catheter ablation for atrial fibrillation (AF) based on AF type.
• The prognostic value of left atrial (LA) and left atrial appendage (LAA) volumes in predicting long-term outcomes after radiofrequency catheter ablation (RFCA) for AF is not well-established.
• Multislice computed tomography (MSCT) is used for anatomical assessment in AF patients undergoing RFCA.

Purpose of the Study:

• To investigate the relationship between LA and LAA volumes, measured by MSCT, and long-term outcomes following RFCA in patients with drug-refractory AF.
• To determine if LA and LAA volumes can predict AF recurrence after RFCA.

Main Methods:

• A cohort of 152 consecutive patients with drug-refractory AF underwent RFCA and MSCT imaging.
• Patients were evaluated for documented AF recurrence during a mean follow-up of 12.6 months.
• LA and LAA volumes were measured using MSCT and correlated with AF recurrence.

Main Results:

• The overall success rate of RFCA was 77.6%.
• Patients with AF recurrence had significantly larger LA volumes (153.8 ± 29.9 mL) compared to those without recurrence (139.2 ± 34.1 mL, p=0.025).
• LAA volumes did not differ significantly between patients with and without AF recurrence (p=0.235).
• An LA volume cutoff of 153.2 mL demonstrated 94% sensitivity and 66% specificity for predicting AF recurrence.
• LA volume was an independent predictor of AF recurrence and permanent AF.

Conclusions:

• LA volume, assessed by MSCT, is a valuable tool for identifying patients at higher risk of AF recurrence after RFCA.
• An LA volume threshold of 153.2 mL accurately predicts AF recurrence post-ablation, whereas LAA volume does not.
• These findings may aid in patient selection for successful AF ablation procedures.