Left Atrial Sphericity: A New Method to Assess Atrial Remodeling. Impact on the Outcome of Atrial Fibrillation Ablation. (14th March 2013)

• Record Type: Journal Article
• Authors: Bisbal, Felipe; Guiu, Esther; Calvo, Naiara; Marin, David; Berruezo, Antonio; Arbelo, Elena; Ortiz‐Pérez, José; de, Teresa María; Tolosana, José María; Borràs, Roger; Sitges, Marta; Brugada, Josep; MONT, LLUÍS
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 24:Number 7(2013:Jul.)
• Page Start: 752
• Page End: 759
• Publication Date: 2013-03-14
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12116
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>Left Atrial Sphericity Predicts AF Ablation Outcome</title> <sec id="jce12116-sec-0010" sec-type="section"> <title> <italic>Background</italic></title> <p>Atrial fibrillation (AF) ablation outcome is mainly determined by atrial remodeling that, nowadays, is only estimated through clinical presentation (persistent vs. paroxysmal) and left atrial (LA) dimension. The aim of the study was to stage the atrial remodeling process using the Left Atrial Sphericity (LASP) and determine whether this technique may help to predict AF ablation outcome.</p> </sec> <sec id="jce12116-sec-0020" sec-type="section"> <title>Methods</title> <p>Consecutive patients who underwent contrast‐enhanced cardiac magnetic resonance angiography before AF ablation were included in the study. Three‐dimensional reconstruction of LA excluding pulmonary veins and the LA appendage was used to define the LA cavity. The LASP was automatically obtained with self‐customized software.</p> </sec> <sec id="jce12116-sec-0030" sec-type="section"> <title>Results</title> <p>106 patients were included and categorized in 3 groups (Gs): discoid‐LA (G1), intermediate‐LA (G2), and spherical‐LA (G3). The G3 patients had larger LA anteroposterior diameter than G1 and G2 patients (47 ± 7 vs 43 ± 6 and 39 ± 5mm; P < 0.001), greater LA volume (90 ± 39 vs 86 ± 24 and 73 ± 20 mm; <italic>P</italic> = 0.012), and higher prevalence of persistent AF (75% vs 48% and 29%; <italic>P</italic> = 0.034) structural heart disease (75% vs 19% and 19%; P < 0.001), and AF recurrence at 12 months follow‐up (58% vs 29% and 5%, P < 0.001). The LASP had linear correlation to predicted probability of recurrence. Multivariate analysis identified LASP (OR 1.320 [1.096–1.591], P = 0.004) and hypertension (OR 3.694 [1.282–10.645]; P = 0.016) as independent risk factors for arrhythmia recurrence.</p> </sec> <sec id="jce12116-sec-0040" sec-type="section"> <title>Conclusion</title> <p>Left Atrial Sphericity is a new independent predictor of recurrence after AF ablation and may be useful in selecting the best candidates for AF ablation.</p> </sec> </abstract>