Biatrial volume, estimated using magnetic resonance imaging, predicts atrial fibrillation recurrence after ablation

Abstract

Introduction:The predictive value of left atrial volume (LAV) in atrial fibrillation (AF) is known, but the relationship of right atrial volume (RAV) and biatrial volume (BAV) with AF recurrence after pulmonary vein isolation (PVI) is not clear. Cardiac magnetic resonance (CMR) imaging allows us to more precisely quantify atrial volume. We investigated LAV, RAV, and BAV as predictors of AF recurrence following PVI in AF patients. Methods and Results:We assessed 100 AF patients (age = 59.8 ± 9.5 years, 74 males, 26 females) who underwent nonenhanced CMR before their first PVI. LAV and RAV were measured using CMR. All patients were in sinus rhythm during CMR. BAV was calculated as the sum of LAV and RAV. During the 8-month follow-up, AF recurrence occurred in 23 patients. LAV, RAV, and BAV were significantly greater in patients with AF recurrence than in those without (LAV, 103.7 ± 25.8 vs 81.8 ± 24.2 mL, P < 0.001; RAV, 109.4 ± 27.0 vs 82.2 ± 19.6 mL, P < 0.001; BAV, 213.1 ± 46.7 vs 164.1 ± 38.7 mL, P < 0.001). Multivariate logistic regression analysis revealed that increased LAV, RAV, and BAV were significantly correlated with AF recurrence. The area under the receiver operation characteristic curve for BAV showed the largest value compared to that of LAV or RAV alone.Conclusions: LAV, RAV, and BAV were independent predictors of AF recurrence after PVI. Quantifying BAV may additionally improve prognostic stratification compared with LAV or RAV. K E Y W O R D Satrial fibrillation, cardiac magnetic resonance imaging, catheter ablation

Development of a Novel Risk Score for Predicting One-Year Mortality Risk in Patients with Atrial Fibrillation using XGBoost-Assisted Feature Selection

“…Those undergoing hemodialysis with new-onset AF exhibit heightened risks of death and stroke [23], and chronic kidney disease and hemodialysis impact mortality, length of stay, and total cost of hospitalization in patients admitted with a primary diagnosis of paroxysmal AF [24]. Furthermore, the biatrial volume predicts AF recurrence after ablation, impacting mortality [25].…”

Association of Atrial Fibrillation Recurrence with Right Coronary Atherosclerosis and Increased Left Arterial Epicardial Fat Following Catheter Ablation—Results of a Multimodality Study

“…It was independently linked to a higher risk of heart failure, cerebrovascular events, and mortality in a single-center study involving 254 subjects with non-valvular AF [ 34 ]. A study based on cardiac MRI, which included patients undergoing pulmonary vein isolation, showed that all three atrial volumes (left, right, and bi-atrial) were significantly correlated with AF recurrence after ablation, but the bi-atrial volume presented the highest AUC value for risk prediction in this context [ 35 ]. This is similar to our results, where we found significant prognostic capacity for all indexed volumes, but the bi-atrial indexed volume presented the largest area under the curve compared with LAVI or RAVI alone.…”

Value of Imaging in the Non-Invasive Prediction of Recurrence after Catheter Ablation in Patients with Atrial Fibrillation: An Up-to-Date Review

“…[ 64 ] demonstrated that LA volume, as determined by preoperative cardiovascular MRI, is a powerful predictor of AF recurrence after CA. Further studies have shown that, in addition to LA volume, RA volume and biatrial volume quantified by MRI can also predict AF recurrence after CA [ 65 ]. Alternatively, LA shape has been found to provide prognostic information for CA treatment [ 14 , 66 ].…”

“…A summary of studies that used MRI to predict recurrence after CA in patients with AF is presented in Table 3 (Ref. [ 13 , 14 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 72 , 74 , 75 , 77 , 78 , 79 ]). Fig.…”