Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation

Jeonggeun Moon, Hye Jeong Lee, Jongwook Yu, Hui Nam Pak, Jong Won Ha, Moon Hyoung Lee, Young Jin Kim, Boyoung Joung

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive. Methods: All 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three-dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured. Results: After a 3-month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26%). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95% confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95% CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF. Conclusions: LA spherical change precedes severe LA enlargement in AF. It predicts 1-year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.

Original languageEnglish
Pages (from-to)713-720
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume40
Issue number6
DOIs
Publication statusPublished - 2017 Jun

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Catheter Ablation
Atrial Fibrillation
Recurrence
Tachycardia
Atrial Pressure
Odds Ratio
Confidence Intervals
Pressure

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{7d0ae968edde47199f383f05efac0e5f,
title = "Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation",
abstract = "Background: Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive. Methods: All 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three-dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured. Results: After a 3-month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26{\%}). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95{\%} confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95{\%} CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF. Conclusions: LA spherical change precedes severe LA enlargement in AF. It predicts 1-year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.",
author = "Jeonggeun Moon and Lee, {Hye Jeong} and Jongwook Yu and Pak, {Hui Nam} and Ha, {Jong Won} and Lee, {Moon Hyoung} and Kim, {Young Jin} and Boyoung Joung",
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Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation. / Moon, Jeonggeun; Lee, Hye Jeong; Yu, Jongwook; Pak, Hui Nam; Ha, Jong Won; Lee, Moon Hyoung; Kim, Young Jin; Joung, Boyoung.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 40, No. 6, 06.2017, p. 713-720.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation

AU - Moon, Jeonggeun

AU - Lee, Hye Jeong

AU - Yu, Jongwook

AU - Pak, Hui Nam

AU - Ha, Jong Won

AU - Lee, Moon Hyoung

AU - Kim, Young Jin

AU - Joung, Boyoung

PY - 2017/6

Y1 - 2017/6

N2 - Background: Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive. Methods: All 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three-dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured. Results: After a 3-month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26%). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95% confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95% CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF. Conclusions: LA spherical change precedes severe LA enlargement in AF. It predicts 1-year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.

AB - Background: Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive. Methods: All 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three-dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured. Results: After a 3-month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26%). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95% confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95% CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF. Conclusions: LA spherical change precedes severe LA enlargement in AF. It predicts 1-year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.

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