Association between Isometric and Allometric Height-indexed Left Atrial Size and Atrial Fibrillation

Aim. To evaluate the impact of the atrial ectopic activity and left ventricular diastolic dysfunction on predicting the effectiveness of pulmonary vein isolation (PVI) in patients with paroxysmal and persistent atrial fibrillation (AF).Methods. 54 patients with paroxysmal and persistent AF and the normal left ventricular ejection fraction were included in the study. Patients underwent Holter monitoring and echocardiography prior to the intervention to identify the predictors of successful PVI. The follow-up was 12 months after the indexed procedure. The effectiveness of treatment was assessed from the third month of the postoperative period. The criterion of the successful treatment was the absence of the AF paroxysms lasting more than 30 seconds, confirmed by Holter, diurnal and / or multi-day monitoring. The Student's t-test was used to assess the reliability of the differences between the variables characterizing the treatment results in the study groups. The discriminant analysis was performed to develop an algorithm that allows predicting the PVI result. A p value <0.05 was considered statistically significant.Results. Premature atrial contraction over 70 per hour can be considered as the predictor of the successful PVI in patients with normal left atrial size. The severe LA enlargement should be considered as a predictor of poor ablation efficacy. The obtained discriminant function allows predicting the effectiveness of PVI in patients with paroxysmal and persistent AF depending on Holter monitoring and echocardiography. Its sensitivity is high for both predicting success and failure of the intervention.Conclusion. Holter monitoring and echocardiography allow predicting the effectiveness of PVI. The intervention's efficacy in the groups of patients with severe LA enlargement and the combination of normal left atrial size with over 70 PAC per hour should be addressed in the further studies.

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Diagnostic importance of fibrillatory wave amplitude: A clue to echocardiographic left atrial size and etiology of atrial fibrillation

Journal of Electrocardiology ◽

10.1016/0022-0736(88)90099-4 ◽

1988 ◽

Vol 21 (3) ◽

pp. 247-251 ◽

Cited By ~ 21

Author(s):

Marei H. Aysha ◽

Adnan S. Hassan

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Wave Amplitude ◽

Left Atrial Size ◽

Atrial Size ◽

Diagnostic Importance

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No Correlation Between Atrial Natriuretic Peptide Concentrations and Echocardiographic Measurements of Left Atrial Size or Left Ventricular Size and Function in Patients with Persistent Atrial Fibrillation

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2005.00009.x ◽

2005 ◽

Vol 28 (s1) ◽

pp. S110-S114 ◽

Cited By ~ 4

Author(s):

BEATA WOŻAKOWSKA-KAPLON ◽

GRZEGORZ OPOLSKI

Keyword(s):

Atrial Fibrillation ◽

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Left Atrial ◽

Persistent Atrial Fibrillation ◽

Left Ventricular ◽

Ventricular Size ◽

Left Atrial Size ◽

Atrial Size ◽

And Function

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Association of epicardial adipose tissue and left atrial size on non-contrast CT with atrial fibrillation: The Heinz Nixdorf Recall Study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeu006 ◽

2014 ◽

Vol 15 (8) ◽

pp. 863-869 ◽

Cited By ~ 33

Author(s):

A. A. Mahabadi ◽

N. Lehmann ◽

H. Kalsch ◽

M. Bauer ◽

I. Dykun ◽

...

Keyword(s):

Atrial Fibrillation ◽

Adipose Tissue ◽

Left Atrial ◽

Epicardial Adipose Tissue ◽

Left Atrial Size ◽

Heinz Nixdorf Recall Study ◽

Atrial Size ◽

Contrast Ct

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Abstract 15901: Radiofrequency Ablation for Persistent Atrial Fibrillation: Earlier Catheter-based Interventions are associated With Better Outcomes and in Direct Association With Markers of Pathways of Atrial Remodeling

Circulation ◽

10.1161/circ.132.suppl_3.15901 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Amr F Barakat ◽

Ayman A Hussein ◽

Mohammed Bassiouny ◽

Ali Hakim ◽

Shadi Al Halabi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Persistent Atrial Fibrillation ◽

Atrial Remodeling ◽

Success Rates ◽

Left Atrial Size ◽

Ablation Time ◽

Atrial Size ◽

Direct Association ◽

First Diagnosis

Introduction: Persistent atrial fibrillation (PerAF) ablation has been associated with significant recurrence rates which could reflect progressive AF-related atrial remodeling. We hypothesized that the first-diagnosis to ablation time for PerAF is a major determinant of success rates and in direct association with pathways of atrial remodeling. Methods: Two-year outcomes were assessed in 1241 patients undergoing first time ablation of PerAF between January 2005 and December 2012 at our institution. The time intervals between the first diagnosis of PerF and the ablation procedures were determined. Patients had echocardiograms and measures of B-type natriuretic peptide (BNP) and C-reactive protein (CRP) before the ablation procedures. During ablations, patients with atrial scarring by voltage were identified. Results: The median time-to-ablation since the first PerAF diagnosis was 3 years (interquartile range 1-6.5). With longer diagnosis-to-ablation time (based on quartiles), there was a significant increase in BNP levels (p=0.01), CRP levels (p<0.0001), left atrial size (p=0.03) and scarring (p=0.04). Atrial arrhythmia recurred after a single ablation in 555 patients (44.7%); and 364 (29.3%) underwent repeat ablations. At last follow-up, 1005 patients (81.0%, 390 on antiarrhythmic medications) were either arrhythmia free or had their arrhythmia controlled. In Cox Proportional Hazard analyzes, BNP levels, CRP levels, left atrial size and scarring were associated with arrhythmia recurrence. The diagnosis-to-ablation time had the strongest association with success rates which persisted in multivariate Cox analyzes (HR for recurrence per +1Log diagnosis-to-ablation time 1.25, 95%CI 1.11-1.42, p<0.0001; 4th vs. 1st quartile 2.27, 95%CI 1.52-3.47, p<0.0001). Conclusions: The success rates with PerAF ablation are highest with early intervention, that is ablation before the progression of atrial remodeling.

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