Abstract 12479: Prognostic Implication of Atrial Pressures in Patients With Nonvalvular Atrial Fibrillation and Preserved Systolic Function Who Undergo Radiofrequency Catheter Ablation: A Pilot Study
Background & Objectives: Pressure overload of atria increases wall stress and induces atrial remodeling in atrial fibrillation (AF). We evaluated the impact of atrial pressure on outcomes of AF after radiofrequency ablation (RFA).
Methods: Pre-procedural mean pressures of the right and left atria (RA and LA) were measured (mRAP and mLAP) in 143 patients (age: 57±11 years, 118 males). RA and LA volumes were determined using computed tomography and indexed to body surface area (RAVI and LAVI).
Results: Persistent AF (PeAF) patients (n=51) had higher mRAP (7±5 vs. 9±6 mm Hg, p=0.01) and mLAP (11±5 vs. 13±7 mm Hg, p=0.04) than paroxysmal AF (PaAF) patients. After a 3-month blanking period, AF recurrences were documented in 22 (24%) PaAF and 31 (61%) PeAF patients (duration: 429±237 days). In the PaAF group, RAVI and LAVI were larger in patients with recurrence (p≤0.05 for all), but mRAP and mLAP were similar. In the PeAF group, mRAP (6±5 vs. 11±6 mm Hg, p=0.006) and mLAP (9±6 vs. 16±6 mm Hg, p≤0.001) were higher in patients with than without recurrence. LAVI was greater in PeAF patients with recurrence, whereas RAVI was similar. mLAP (OR: 1.33, 95% CI: 1.05-1.68, p=0.02) and LAVI (10 ml/m2 increase; OR: 1.65, 95% CI: 1.01-2.72, p=0.05) independently predicted recurrence in PeAF. However, either atrial pressure failed to predict recurrence in the PaAF group.
Conclusions: High LA pressure and large LA volume were independently associated with AF recurrence after RFA in PeAF. However, neither atrial pressure played a prognostic role in PaAF.
- © 2013 by American Heart Association, Inc.