Remodeling Disparity between Left Atrium and Appendage Relates to Recurrence after Atrial Fibrillation Ablation
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概要
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<B>Hypothesis:</B> Different alterations of volume between left atrium (LA) and appendage (LAA) can predict clinical outcome of ablation of atrial fibrillation (AF). <B>Methods:</B> Among 386 consecutive patients (37% non-paroxysmal AF), 284 patients with LAD<45 mm and 102 with LAD≥45 mm were assessed. LA diameter (LAD) was measured by transthoracic echocardiography, and volumes of LA and LAA were calculated by 3-D CT scan. <B>Results:</B> During mean 22±16 months, rate of freedom from recurrence was higher in LAD<45 mm compared with LAD≥45 mm (80.3% vs 61.8%, p<0.001). In patients with LAD<45 mm, LAD and LAA volume were significantly greater in patients with recurrence compared with those without recurrence (40.1±3.9 vs 37.8±4.4 mm, p<0.001; 12.8±12.2 vs 9.3±4.0 ml, p=0.042), whereas there was no significant difference in LA volume. In patients with LAD≥45 mm, LAA volume was significantly larger in patients with recurrence than those without recurrence (15.5±8.9 vs 11.8±5.6 ml, p=0.024), however, there was no difference in LAD and LA volume. In patients with LAD<45 mm, LAD was associated with higher recurrence rate (OR 1.127; 95%CI 1.031–1.232; p=0.008), whereas in patients with LAD≥45 mm, LAA volume independently predicted recurrence after AF ablation (OR 1.094; 95%CI 1.003–1.194; p=0.044). <B>Conclusions:</B> Larger LAA volume predicts recurrence after ablation of AF in patients with enlarged LA. These finding suggests that LAA is an important substrate of AF in remodeled LA.
著者
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Ko Kyoung-jeong
Korea University Cardiovascular Center
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Kim Young-hoon
Korea University Cardiovascular Center
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Choi Jong-il
Korea Atomic Energy Research Institute
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Park Sang-Weon
Korea University Medical Center
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Ban Ji-Eun
Korea University Medical Center
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Park Yae-Min
Korea University Medical Center
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Euy Lim
Korea University Medical Center
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Seong Joo-Yong
Korea University Medical Center
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Han Boo-Kyoung
Korea University Medical Center
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Shin Soon-Hwa
Korea University Medical Center
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Ko Kyoung-Jeong
Korea University Medical Center
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