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Left Atrial Wall Thickness Measured by a Machine Learning Method Predicts AF Recurrence After Pulmonary Vein

Daniel A Gomes1, Ana Rita Bello1, Pedro Freitas1,2

  • 1Department of Cardiology, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal.

Journal of Cardiovascular Electrophysiology
|November 29, 2024
PubMed
Summary
This summary is machine-generated.

Left atrial wall thickness (LAWT) is a key indicator of atrial fibrillation (AF) progression. Increased LAWT independently predicts long-term AF recurrence after pulmonary vein isolation (PVI), highlighting its clinical significance.

Keywords:
atrial fibrillationatrial remodelingcardiac CTleft atrial wall thicknessmachine learningpulmonary vein isolation

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Left atrial (LA) remodeling is crucial in atrial fibrillation (AF) progression.
  • Left atrial wall thickness (LAWT) indicates structural remodeling, but its prognostic value for AF outcomes is unclear.
  • This study investigates the link between LAWT and AF recurrence post-pulmonary vein isolation (PVI), and its association with LA fibrosis.

Purpose of the Study:

  • To determine if LAWT predicts AF recurrence after PVI.
  • To assess the relationship between LAWT and LA fibrosis.
  • To evaluate LAWT as a prognostic marker in AF patients undergoing PVI.

Main Methods:

  • A single-center registry included 439 patients undergoing radiofrequency PVI (2016-2018).
  • Pre-ablation CT scans were used to measure mean LAWT via a semi-automated machine learning method.
  • AF recurrence was the primary endpoint, with a subgroup undergoing cardiac MRI to assess LA fibrosis.

Main Results:

  • Higher LAWT was an independent predictor of AF recurrence after PVI (aHR: 4.25).
  • AF recurrence rates increased significantly with higher LAWT terciles (11%, 15%, 21%/year).
  • A moderate correlation was found between LAWT and LA fibrosis (Spearman R 0.468, p < 0.001).

Conclusions:

  • Mean LAWT, measurable with machine learning software, independently predicts long-term AF recurrence post-PVI.
  • Increased LAWT signifies a higher risk of AF relapse.
  • Further research is needed to explore tailored therapies for patients with elevated LAWT.