Left atrial appendage volume is an independent predictor of atrial arrhythmia recurrence following cryoballoon pulmonary vein isolation in persistent atrial fibrillation.
atrial fibillation
catheter ablation
cryoballoon
left atrial appendage
left atrium
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2023
2023
Historique:
received:
21
03
2023
accepted:
02
06
2023
medline:
5
7
2023
pubmed:
5
7
2023
entrez:
5
7
2023
Statut:
epublish
Résumé
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation in persistent AF (persAF), and cryoballoon PVI emerged as an initial ablation strategy. Symptomatic atrial arrhythmia recurrence following successful PVI in persAF is observed more frequently than in paroxysmal AF. Predictors for arrhythmia recurrence following cryoballoon PVI for persAF are not well described, and the role of left atrial appendage (LAA) anatomy is uncertain. Patients with symptomatic persAF and pre-procedural cardiac computed tomography angiography (CCTA) images undergoing initial second-generation cryoballoon (CBG2) were enrolled. Left atrial (LA), pulmonary vein (PV) and LAA anatomical data were assessed. Clinical outcome and predictors for atrial arrhythmia recurrence were evaluated by univariate and multivariate regression analysis. From May 2012 to September 2016, 488 consecutive persAF patients underwent CBG2-PVI. CCTA with sufficient quality for measurements was available in 196 (60.4%) patients. Mean age was 65.7 ± 9.5 years. Freedom from arrhythmia was 58.2% after a median follow-up of 19 (13; 29) months. No major complications occurred. Independent predictors for arrhythmia recurrence were LAA volume (HR 1.082; 95% CI, 1.032 to 1.134; LAA volume and mitral regurgitation were independent predictors for arrhythmia recurrence following cryoballoon ablation in persAF. LA volume was less predictive and correlated with LAA volume. LAA morphology did not predict the clinical outcome. To improve outcomes in persAF ablation, further studies should focus on treatment strategies for persAF patients with large LAA and mitral regurgitation.
Identifiants
pubmed: 37404733
doi: 10.3389/fcvm.2023.1190860
pmc: PMC10315839
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1190860Informations de copyright
© 2023 Pongratz, Riess, Hartl, Brück, Tesche, Ebersberger, Helmberger, Crispin, Wankerl, Dorwarth, Hoffmann and Straube.
Déclaration de conflit d'intérêts
Straube received honoraria for lectures from Medtronic, Boston Scientific, Philips, Bristol Myers-Squibb, and Astra Zeneca outside the submitted work. Dorwarth reports honoraria for lectures from Medtronic Inc., Bristol-Myers-Squibb, and Astra Zeneca, outside the submitted work. Hoffmann is head of the department; the department received compensation for participation in clinical research trials outside the submitted work from Abbott, Bayer, Biotronik, Boehringer Ingelheim, Edwards, Elixier, Medtronic, and Stentys. Hartl participates in the EP fellowship from Boston Scientific, received educational support from Biotronik, Daiichi Sankyo and honoraria for lectures from Bristol Myers Squibb outside the submitted word. Dres. Brueck, Crispin, Ebersberger, Helmberger, Pongratz, Tesche, and Wankerl have nothing declared.
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