Right Atrial Anatomical Remodeling Affects Early Outcomes of Nonvalvular Atrial Fibrillation After Radiofrequency Ablation

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  • Moon Jeonggeun
    Cardiology Division, Department of Internal Medicine, Gachon University of Medicine and Science
  • Jin Hong Yoo
    Department of Radiology, Yonsei University College of Medicine
  • Shim Jaemin
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
  • Hwang Hye-Jin
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
  • Kim Jong-Youn
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
  • Pak Hui-Nam
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
  • Lee Moon-Hyoung
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
  • Joung Boyoung
    Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine

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Background: The impact of the right atrial (RA) anatomical remodeling on outcomes of atrial fibrillation (AF) after radiofrequency ablation (RFA) is unclear. Methods and Results: Sixty-three patients (50 men, 57±10 years, 23 persistent AF [PeAF]) who underwent RFA for AF were enrolled. Both RA and left atrial (LA) volumes, measured with multidetector computed tomography, as well as echocardiographic parameters were compared between subjects with early (<3 months, n=13) or 1-year (n=19) recurrence after RFA and without recurrence. The RA volume index (RAVI) was larger (98±21 vs. 77±22ml/m2) and PeAF was more common (62% vs. 30%) in the early recurrence group (P<0.05 for all), whereas the LA volume index (LAVI) was similar between the 2 groups (78±15 vs. 72±19ml/m2, P=0.23). Notably, RAVI was the only independent predictor of early recurrence (for each 10ml/m2 increase, OR: 1.650, 95%CI: 1.017-2.677, P=0.04). PeAF was the only independent predictor of 1-year recurrence after RFA (OR: 4.496, 95%CI: 1.110-18.211, P=0.04), whereas RAVI and LAVI were not. Conclusions: RA anatomical remodeling might affect the early recurrence of AF after RFA. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence of AF after RFA. (Circ J 2012; 76: 860-867)<br>

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  • Circulation Journal

    Circulation Journal 76 (4), 860-867, 2012

    一般社団法人 日本循環器学会

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