Abstract 16547: Pulmonary Vein Volume is the Major Predictor of Atrial Fibrillation Recurrence After Successful Radiofrequency Catheter Ablation
Background: Predictive factors of recurrence after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) are poorly defined. This study evaluated the impact of structural changes in the pulmonary veins (PVs) and left atrium (LA) on the outcome of RFCA for AF.
Methods and Results: Sixty-five patients under 64 years with AF, including 42 with paroxysmal AF (PAF) and 23 with chronic AF (CAF), underwent circumferential PV isolation and additional ablation (inferior GP ablation, superior vena cava isolation). All patients had a preserved left ventricular function (ejection fraction, 65.0±6.9%) and underwent contrast CT scans before the RFCA procedure. The LA and sum of the 4 major PV volumes were calculated in 3-D images using CT reconstruction software (syngo InSpace EP, Siemens). The PV ostium was defined as the point of inflection between the LA walland PV wall. PV volume was measured from the PV ostium to the first major branching (Figure 1). Recurrence of AF was electrocardiographically confirmed in 18 patients (PAF 9, CAF 9) within 5.2 ± 2.9 months (3 -12 months) after the procedure. The results are shown in the Table. PV volume was an independent key predictor of AF recurrence especially in PAF, whereas the LA structural parameters were not. Other factors including the age, body mass index, the disease duration prior to RFCA of, the type of AF (PAF or CAF) or PV ostial diameters did not correlate with the recurrence rate in this study.
Conclusions: This study demonstrated the importance of PV volume measurement in AF to predict successful RFCA.
- © 2013 by American Heart Association, Inc.