Purpose: We investigate the role of left atrial volume (LAV) as a predictor of outcome following pulmonary vein isolation (PVI) in patients with exclusive paroxysmal atrial fibrillation (AF).
Methods: PVI was performed in 213 patients (80 females, aged 60 ± 10 years) with paroxysmal AF using either the pulmonary vein ablation catheter (PVAC, n = 78) or conventional single-tip ablation (n = 135). LAV was assessed by multi-detector computed tomography (n = 39) or cardiac magnetic resonance imaging (n = 174) prior to ablation. LA diameter (LAD) and LA area were determined by echocardiography. Patients were followed up for 12 months clinically and with 72-h Holter ECG.
Results: The mean LAV was 85 ± 28 ml (range, 22-189 ml). Mean LAD and mean LA area were 43 ± 6 mm and 23 ± 6 cm². After a follow-up period of 18 ± 5 months, 202 patients were analyzed. AF recurrence was documented in 50 (23%) patients. Univariate analysis showed age (59 ± 11 vs. 65 ± 6 years, p = 0.049), LA area (23 ± 5 vs. 27 ± 6 cm², p = 0.03), and LAV (80 ± 27 vs. 96 ± 28 ml, p = 0.04) to be significantly associated with the outcome. Multivariate analysis revealed that none of these parameters were statistically significant (hazards ratio LAV, 0.52-1.12, p = 0.058; LA area, 0.63-1.14, p = 0.069; and age, 0.90-1.09, p = 0.41). In the case of AF recurrence, patients with LAV >95 ml showed a significantly higher probability for the occurrence of persistent AF (24% vs. 8%, p = 0.02).
Conclusions: The assessment of LA size should not be incorporated as a main factor with regard to predicted ablation success in patients with paroxysmal AF being considered for PVI, as PVI may be successful even with considerable LA enlargement. Ablation should be performed promptly in patients with LAV ≤ 95 ml to prevent further LA dilatation, as patients with LAV >95 ml have an increased probability to develop persistent AF in the case of ablation failure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10840-011-9641-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Assessment of Emphysema on X-ray Equivalent Dose Photon-Counting Detector CT: Evaluation of Visual Scoring and Automated Quantification Algorithms.
Invest Radiol
October 2024
From the Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Zurich, Switzerland (B.K., F.E., J.K., T.F., L.J.); Advanced Radiology Center, Department of Diagnostic Imaging and Oncological Radiotherapy, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy (C.S., A.R.L.); and Section of Radiology, Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy (A.R.L.).
Objectives: The aim of this study was to evaluate the feasibility and efficacy of visual scoring, low-attenuation volume (LAV), and deep learning methods for estimating emphysema extent in x-ray dose photon-counting detector computed tomography (PCD-CT), aiming to explore future dose reduction potentials.
Methods: One hundred one prospectively enrolled patients underwent noncontrast low- and chest x-ray dose CT scans in the same study using PCD-CT. Overall image quality, sharpness, and noise, as well as visual emphysema pattern (no, trace, mild, moderate, confluent, and advanced destructive emphysema; as defined by the Fleischner Society), were independently assessed by 2 experienced radiologists for low- and x-ray dose images, followed by an expert consensus read.
Ga-pentixafor PET/CT Is a Supplementary Method for Primary Aldosteronism Subtyping Compared with Adrenal Vein Sampling.
Mol Imaging Biol
December 2024
Department of Nuclearuclear Medicine, Peking University First Hospital, Beijing, China.
Purpose: To investigate the diagnostic efficacy of Ga-pentixafor positron emission tomography/computed tomography (PET/CT) in primary aldosteronism (PA) subtyping and lateralization of aldosterone secretion in PA patients.
Procedures: 37 patients who were diagnosed with PA, were prospectively enrolled in the study, and underwent adrenal vein sampling (AVS) after Ga-pentixafor PET/CT was conducted. Lateralization index (LI), defined as aldosterone/cortisol ratio in the dominant side to the contralateral adrenal vein when bilateral adrenal vein catheterization succeeded, and the aldosterone/cortisol ratio in the left adrenal vein to IVC (LAV/IVC) when the catheterization of right adrenal vein failed, were applied to determine lateralization side.
Reliability and Validity of the Turkish Version of Work-Related Questionnaire for Upper Extremity Disorders (WORQ-UP).
Med Lav
December 2024
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Mugla Sitki Kocman University, Mugla, Türkiye.
Background: The Work-Related Questionnaire for Upper Extremity Disorders (WORQ-UP) serves as a patient-reported outcome measure to identify work-related limitations in individuals with upper extremity musculoskeletal disorders. This study aims to adapt the WORQ-UP into Turkish and subsequently evaluate its validity and reliability.
Methods: The Turkish WORQ-UP, along with the previously validated Turkish Quick DASH, were administered to 136 patients.
Per- And Poly-Fluoroalkyl Substances (PFAS) Exposure and Risk of Breast, and Female Genital Cancers: A Systematic Review and Meta-Analysis.
Med Lav
December 2024
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Background: PFASs, synthetic chemicals, can be encountered by humans through occupational or environmental exposure, and some reports suggest that they can disrupt endocrine and hormonal activities. In this comprehensive review and meta-analysis, we explored the connection between exposure to PFASs and the risks of breast and female genital cancers.
Methods: We systematically reviewed the literature from IARC Monographs, ATSDR documents, and PubMed (as of January 2024) for cohort, case-control, and ecological studies on PFAS exposure and breast or female genital cancers.
Background: Atrial volume index and atrial volume have recently been identified as predictors of atrial fibrillation (AF) recurrence following electrical cardioversion or radiofrequency ablation. However, most studies have reported the relationship between LAVI/LAV and AF recurrence, whereas there is little information on the relationship between RAVI/RAV and AF recurrence. Therefore, we performed a meta-analysis to assess the relationship between the risk of AF recurrence and RAVI/RAV in patients with AF who underwent electrical cardioversion or radiofrequency ablation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!