Left Atrial Size and Left Ventricular End-Systolic Dimension Predict the Progression of Paroxysmal Atrial Fibrillation After Catheter Ablation

Ying Chieh Liao, Jo Nan Liao, Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Tze Fan Chao, Fa Po Chung, Ta Chuan Tuan, Abigail Louise D. Te, Rohit Walia, Shinya Yamada, Chung-Hsing Lin, Chin Yu Lin, Yao Ting Chang, Suresh Allamsetty, Wen Chung Yu, Jing Long Huang, Tsu Juey Wu, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Introduction: Although rare, some paroxysmal atrial fibrillations (AF) still progress despite radiofrequency (RF) ablation. In the study, we evaluated the long-term efficacy of RF ablation and the predictors of AF progression. Methods: A total of 589 paroxysmal AF patients (404 men and 185 women; aged 54 ± 12 years) who received 3-dimensional mapping and ablation were enrolled. Their clinical parameters and electrophysiological characteristics were collected. They were divided into Group 1 (N = 13, with AF progression) and Group 2 (N = 576, no AF progression). AF progression was defined as recurrence of persistent AF. Results: Group 1 patients had larger left atrial (LA) diameter, larger left ventricle (LV) end-systolic and end-diastolic diameters, poorer LV systolic function, and more amiodarone use at baseline. After 1.2 ± 0.5 procedures, 123 (21%) patients experienced recurrence during 56 ± 29 months’ follow-up. In the multivariate analysis, LA diameter (P = 0.018, HR = 1.12, 95% CI = 1.02–1.24) and LV end-systolic diameter (P = 0.005, HR = 1.10, 95% CI = 1.03–1.17) independently predicted AF progression. LA diameter >43 mm and LV end-systolic diameter >31 mm were the best cut-off values for predicting AF progression by ROC analysis. AF progression rate achieved 19% if they had both larger LA diameter (>43 mm) and LV end-systolic diameter (>31 mm). Conclusion: RF ablation prevents the progression of paroxysmal AF effectively, except in patients with increased LA diameter and LV end-systolic diameter on echocardiogram, suggesting more aggressive rhythm control therapies should be considered in these patients.

Original languageEnglish
Pages (from-to)23-30
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Keywords

  • ablation
  • atrial fibrillation
  • left atrial size
  • predictor
  • progression

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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