Changes in left atrial size in patients with persistent atrial fibrillation: a prospective echocardiographic study with a 5-year follow-up period

2005 ◽  
Vol 101 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Beata Wożakowska-Kapłon
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Left Atrial Size ◽  
Echocardiographic Study ◽  
Atrial Size

scholarly journals HOLTER MONITORING AND ECHOCARDIOGRAPHY FOR PREDICTING THE EFFECTIVENESS OF PULMONARY VIEN ISOLATION IN PATIENTS WITH PAROXYSMAL AND PERSISTENT ATRIAL FIBRILLATION

2018 ◽  
Vol 7 (3) ◽  
pp. 12-23
Author(s):  
A. V. Tregubov ◽  
Yu. V. Shubik
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Atrial Size ◽  
Ventricular Ejection Fraction ◽  
Atrial Size ◽  
The Impact

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.

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 ◽  
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.

scholarly journals EFFECT OF CONVERGENT PROCEDURE ON LEFT ATRIAL SIZE AND VENTRICULAR FUNCTION IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION

2012 ◽  
Vol 59 (13) ◽  
pp. E594 ◽  
Author(s):  
Janez Toplisek ◽  
andrej pernat ◽  
borut gersak ◽  
Nada Ruzic Medvescek ◽  
Boris Robic ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Function ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Left Atrial Size ◽  
Atrial Size

scholarly journals Correlation Between CHA2DS2-VASc Score and Left Atrial Size in Patients With Atrial Fibrillation: A More Than 15-Year Prospective Follow-Up Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chin-Feng Tsai ◽  
Pang-Shuo Huang ◽  
Jien-Jiun Chen ◽  
Sheng-Nan Chang ◽  
Fu-Chun Chiu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Cox Model ◽  
Risk Scores ◽  
Left Atrial Size ◽  
Atrial Size ◽  
The Mean ◽  
Ischemic Attack ◽  
Univariate Analyses

Background: Left atrial (LA) size represents atrial fibrillation (AF) burden and has been shown to be a predictor for AF stroke. The CHA2DS2-VASc score is also a well-established predictor of AF stroke. It is unknown to cardiologists whether these two risk scores are correlated, whether both are independent prognostic predictors and complimentary to each other, or whether one of them is a major determinant of stroke risk for AF patients.Method: A total of 708 patients from the National Taiwan University Atrial Fibrillation Registry were longitudinally followed up for more than 15 years. Left atrial size was measured by M mode of echocardiography. Adverse thromboembolic endpoints during follow-up were defined as ischemic stroke or transient ischemic attack.Results: The mean age was 72.1 ± 12.9 years, with 53% men. Both LA size and CHA2DS2-VASc score were associated with the risk of stroke in univariate analyses. There was a weak but significant positive correlation between LA size and CHA2DS2-VASc score (r = 0.17, P &lt; 0.0001). Patients with higher CHA2DS2-VASc scores had a higher mean LA size (P &lt; 0.01 for trend). When combining LA size and CHA2DS2-VASc score in the multivariable Cox model, only CHA2DS2-VASc score remained statistically significant [HR 1.39 (1.20–1.63); P &lt; 0.001].Conclusion: LA size is not an independent predictor of AF stroke, and calculation of CHA2DS2-VASc score may be an alternative to measurement of echocardiographic LA size when evaluating the risk of stroke for AF patients.

P3761Correlation between CHA2DS2-VASc score and left atrial size in patients with atrial fibrillation: an upto 15-year prospective follow-up study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T T L Lin ◽  
L Y Lin ◽  
C T T Tsai
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Stroke Risk ◽  
Cox Model ◽  
Univariate Analysis ◽  
P Value ◽  
Left Atrial Size ◽  
Positive Correlation ◽  
Atrial Size

Abstract Background Left atrial (LA) size represents atrial fibrillation (AF) burden and a predictor of AF-related stroke. CHA2DS2-VASc score is also a well-established predictor of AF-related stroke. It is unknown whether these two factors are correlated and complimentary to each other, or one of them is a major determinant of stroke risk for AF patients. Methods A total of 708 patients from the National Taiwan University AF Registry were followed upto 15 years. LA size was measured by M-mode of echocardiography and the CHA2DS2-VASc score was calculated as measures of stroke risk. Primary endpoints during follow-up were defined as ischemic strokes or transient ischemic accidents. Results Both LA size and CHA2DS2-VASc score were associated with the risk of stroke in univariate analyses (c statistic 0.662 [0.601 to 0.723] for CHA2DS2-VASc score and 0.595 [0.516 to 0.674] for LA size). There was a positive correlation between LA size and CHA2DS2-VASc score (r=0.17, P<0.0001). Patients with higher CHA2DS2-VASc scores had a higher mean LA size (P<0.01 for trend). When combining LA size and CHA2DS2-VASc score in the multivariate Cox model, only CHA2DS2-VASc score remained statistically significant to predict the thromboembolic endpoint (hazard ratio 1.39 [1.20–1.63]; P<0.001). Mode of anlysis Harzard ratio (95% confidence interval) P value Univariate analysis*   CHADS2-VASc score 1.42 (1.22–1.66) <0.001   Left Atrial Size 1.30 (1.04–1.62) 0.019 Multivariate analysis*   CHADS2-VASc score 1.39 (1.20–1.63) <0.001   Left atrial size 1.20 (0.96–1.48) 0.106 Conclusion There is a positive correlation between echocardiographic LA size and CHA2DS2-VASc score. LA size is not an independent predictor of AF-related stroke, but provides a diagnostic value to predict stroke risk through its association with CHA2DS2-VASc score. Calculation of CHA2DS2-VASc score may replace measurement of echocardiographic LA size when evaluating the risk of AF-related stroke.

Left Atrial Size in Paroxysmal Atrial Fibrillation: Echocardiographic Evaluation and Follow-Up

Cardiology ◽  
1992 ◽  
Vol 80 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Aldo S. Villecco ◽  
Germano Pilati ◽  
Giampaolo Bianchi ◽  
Lucia Zanardi
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Size ◽  
Echocardiographic Evaluation ◽  
Atrial Size
Sign in / Sign up

Export Citation Format

Share Document