Reduction of Left Atrial Volume as a Predictor for the Recurrence of Atrial Fibrillation after Pulmonary Vein Isolation

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Background: Recent technological advances have improved the outcome of the pulmonary vein isolation (PVI). However, the predictors of atrial fibrillation (AF) recurrence after PVI are not completely understood. The aim of this study was to investigate the predictors for AF recurrence after PVI. Methods: Thirty three consecutive patients with drug-refractory chronic AF were treated with PVI under Carto-merge guidance. Left atrial (LA) volume and left ventricular function were assessed with multislice computed tomography (CT), echocardiography and plasma brain natriuretic peptide (BNP) before and 3 months after PVI. Moreover, the rate of change in ejection fraction, LA volume index, CT LA volume and BNP were measured. Several parameters of patients with maintained sinus rhythm and were compared with those with recurrent AF. Results: Of 33 patients, 19 patients had recurrent AF during follow up. Only the rate of change in CT LA volume was predictive of AF recurrence (0.70±0.10 vs 0.87±0.12, P=0.002). Conclusions: The reduction rate of CT LA volume can be used as the predictor for AF recurrence after PVI.