Predictive value of left atrial size for atrial fibrillation recurrence after single circumferential pulmonary vein isolation: a systematic review and meta-analysis of observational studies. (12th October 2011)

• Record Type: Journal Article
• Authors: Jianhui, Zhuang; Kai, Tang; Xiankai, Li; Wenhui, Peng; Yawei, Xu
• Is Part Of: Heart. Volume 97(2011)Supplement 3
• Page Start: A187
• Page End: A187
• Publication Date: 2011-10-12
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2011-300867.549
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: LA enlargement is a well-known consequence of AF. However, whether dilated atrium predicts postablation AF recurrence is controversial. We undertook a systematic review and meta-analysis to analyse the association between left atrial (LA) diameter and atrial fibrillation (AF) recurrence after single circumferential pulmonary vein isolation (CPVI) and the potential mechanism. Methods: Electronic databases and bibliographies of retrieved studies were researched. Eligible studies were divided into three groups according to timing of follow-up and subanalyses were conducted based on AF type and blanking period of 3 months. Results: 27 studies with a total of 4486 individuals met the inclusion criteria. The summary WMD of LA diameter between patients with and without recurrence was 1.84 mm (95% CI 1.31 to 2.37; p<0.00001). LA diameter was significantly associated with the risk of postablation recurrence in patients followed up over 3 months (WMD: 1.87 mm; 95% CI 1.28 to 2.46; p<0.00001), as well as in patients with paroxysmal AF (WMD: 1.64 mm; 95% CI 1.06 to 2.23; p<0.00001). However, in 3-month and non-paroxysmal subgroups, no significant differences in mean LA diameter were observed in patients with recurrence versus non-recurrence. Conclusions: Dilated LA significantly increases the risk of AF recurrence after single CPVI, especially in patients with paroxysmal AF followed up over 3 months.