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Left atrioventricular coupling index assessed by cardiac CT as a predictive marker for atrial fibrillation recurrence
Guoxiang Du1,2, Guoliang Lin3, Hai Liao1
1Department of Nuclear Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Insights
The left atrioventricular coupling index (LACI) predicts atrial fibrillation (AF) recurrence after ablation. Higher LACI values indicate a greater risk of AF recurrence, improving risk assessment post-ablation.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- The left atrioventricular coupling index (LACI) is a known predictor of cardiovascular events.
- Its role in predicting atrial fibrillation (AF) recurrence after ablation is not well-established.
Purpose of the Study:
- To evaluate the predictive value of LACI, measured by cardiac CT, for AF recurrence post-ablation.
- To compare LACI's predictive capacity against traditional parameters like left atrial volume index.
Main Methods:
- Retrospective analysis of 130 AF patients undergoing cardiac CT before ablation.
- LACI calculated as the ratio of diastolic left atrial to left ventricular volume.
- Multivariate logistic regression and Kaplan-Meier curves used to assess LACI's association with AF recurrence.
Main Results:
- AF recurrence occurred in 29.2% of patients at 18 months.
- Patients with recurrence had significantly higher LACI (129.56±48.02% vs. 84.58±28.78%, P<0.001).
- LACI was an independent predictor of recurrence (OR=9.51, P=0.005) with superior AUC (0.815 vs. 0.779).
Conclusions:
- LACI is a strong, independent predictor of AF recurrence after ablation.
- LACI offers enhanced risk discrimination compared to traditional parameters.
- Cardiac CT-assessed LACI improves clinical utility for pre-ablation risk stratification.
Background:
The left atrioventricular coupling index (LACI) is a significant predictor of cardiovascular events, heart failure, and atrial fibrillation (AF). However, its predictive efficacy for AF recurrence after ablation remains underexplored.
Objectives:
This study aimed to evaluate the predictive value of LACI, assessed by cardiac computed tomography (CT), for AF recurrence following ablation.
Methods:
We performed a retrospective analysis of 130 AF patients who underwent cardiac CT before ablation at our institution from January 2019 to March 2021. LACI, defined as the ratio of left atrial to left ventricular volume during diastole, was analyzed using multivariate binary logistic regression to determine its association with AF recurrence. Kaplan-Meier survival curves assessed the duration of asymptomatic survival post-ablation.
Results:
At 18 months, 29.2% (38/130) of patients experienced recurrence. Patients with recurrence had significantly higher LACI compared to those without (129.56 ± 48.02% vs. 84.58 ± 28.78%, P < 0.001). Multivariate analysis identified LACI as an independent risk factor for recurrence (OR = 9.51, 95% CI 1.99-45.34, P = 0.005), showing superior predictive capacity compared to the left atrial volume index (AUC: 0.815 vs. 0.779, P < 0.001). Kaplan-Meier curves demonstrated significantly lower cumulative AF recurrence-free survival in patients with LACI ≥ 89%.
Conclusion:
LACI is a strong and independent predictor of AF recurrence post-ablation, offering superior risk discrimination over traditional left atrial and left ventricular parameters, thereby enhancing the clinical utility of cardiac CT before AF ablation.
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