Impact of Right Atrial Structural Remodeling on Recurrence After Ablation for Atrial Fibrillation

Overview

Journal J Arrhythm

Publisher Wiley

Date 2021 Jun 18

PMID 34141012

Citations 5

Authors

Takahito Takagi

Keijiro Nakamura

Masako Asami

Yasutake Toyoda

Yoshinari Enomoto

Masao Moroi

Mahito Noro

Kaoru Sugi

Masato Nakamura

Affiliations

Soon will be listed here.

Abstract

Background: Recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is associated with left atrial (LA) remodeling; however, its association with right atrial (RA) remodeling remains unclear.

Objective: This study aimed to identify whether RA structural remodeling could predict recurrence of AF after PVI.

Methods: This study prospectively analyzed 245 patients with AF who had undergone PVI. RA and LA volumes were determined by contrast-enhanced computed tomography. Atrial structural remodeling was defined as an atrial volume of ≥110 mL according to previous reports and receiver operating characteristic curve analysis.

Results: After excluding 32 patients, 213 patients were analyzed. During a follow-up period of 12 months, 41 patients (19%) demonstrated atrial arrhythmia recurrence after PVI. With the Cox proportional-hazards model, RA structural remodeling was the only predictor of arrhythmia recurrence (hazard ratio, 1.012; 95% confidence interval 1.003-1.021; = .009). Kaplan-Meier analysis showed that arrhythmia recurrence was more frequent in the RA structural remodeling group compared with the group without RA remodeling (log-rank, < .001), and the arrhythmia-free survival rates in these groups at 12 months were 68.0% and 91.4%, respectively. Additionally, there was a significant difference in recurrence-free survival after RA structural remodeling in each type of AF (log-rank, < .001).

Conclusions: RA structural remodeling is a useful predictor of clinical outcome after PVI regardless of the type of AF. Our results suggest that patients without RA structural remodeling may be good candidates for successful ablation with PVI.

Citing Articles

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Impact of right atrial structural remodeling on recurrence after ablation for atrial fibrillation.

Takagi T, Nakamura K, Asami M, Toyoda Y, Enomoto Y, Moroi M J Arrhythm. 2021; 37(3):597-606.

PMID: 34141012 PMC: 8207433. DOI: 10.1002/joa3.12541.

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