Abstract 15884: A Simple Anatomical Index Predicting the Patients Suitable for Catheter Ablation of Atrial Fibrillation

Abstract

INTRODUCTON: We had previously reported that the shorter distance of mitral isthmus, between RIPV and mitral annulus and the larger cross-sectional area of RSPV were associated with AF elimination after catheter ablation (CA). In this study, using a simple index, which is combined with those parameters, we sought to predict the suitable patients for CA.

METHODS: Out of 123 consecutive patients with AF, 104 without left common pulmonary vein (PV) and/or right middle PV were enrolled in this study. (mean LA size 42 ±7 mm, paroxysmal 61%, mean follow-up period 10 ±6 months). The distance of mitral isthmus (dMI) (mm), between RIPV and MA (dRI-MA) (mm) and the cross-sectional area of RSPV (cRSPV) (cm2), were measured on 3D-CT image using the NavX system (St. Jude Medical, Inc., St. Paul, Minnesota). The index (dMI) was defined as the ratio of cRSPV to dMI, the index (dRI-MA) as the ratio of cRSPV to dRI-MA, respectively.

RESULTS: 73 patients (70%) were free from AF after a single procedure. Receiver-operator characteristic curve analysis yielded an optimal cutoff value for the each index of 0.071, 0.055 (AUC 0.867, 0.843; 95% confidence interval: 0.79 to 0.94, 0.76 to 0.92; p<0.001, p<0.001, respectively) (Figure). Sensitivity, specificity, positive and negative predictive values for this cut-off value were 75%, 73%; 87%, 84%; 93%,91% and 60%, 43%, respectively. CONCLUSION: The simple anatomical index, combined assessment of cRSPV and dMI using 3D-CT imaging can be useful to select the suitable patients for CA of atrial fibrillation.