The Right to Left Atrial Volume Ratio Predicts Outcomes after Circumferential Pulmonary Vein Isolation of Longstanding Persistent Atrial Fibrillation

Sasaki, Takehito; Nakamura, Kohki; Naito, Shigeto; Minami, Kentaro; Koyama, Keiko; Yamashita, Eiji; Kumagai, Koji

doi:10.1111/pace.12953

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…Although the enlargement of atrial size between the LA and RA in patients with paroxysmal AF is similar in magnitude, physicians have focused more on the increase in LA size than the RA. However, recent clinical studies demonstrated that RA enlargement was independently associated with AF recurrence after catheter ablation in patients with paroxysmal AF and also persistent AF . Simultaneous evaluation of RA and LA size is important for AF management.…”

Section: Discussionsupporting

confidence: 47%

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

Kumagai

Iwayama

Arimoto

et al. 2018

Pacing Clinical Electrophis

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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

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Section: Discussionsupporting

confidence: 47%

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

Kumagai

Iwayama

Arimoto

et al. 2018

Pacing Clinical Electrophis

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“…RA diameter predicts ablation outcomes only in patients with paroxysmal AF and concurrent LA enlargement. In recent years, Sasaki et al reported that the ratio of RA volume index to LA volume index is a risk factor for AF recurrence 10 . This previous study enrolled patients with only persistent AF.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that RA diameter can affect the early recurrence of AF after ablation 8 . Others have also reported that RA anatomical remodeling can predict the success of AF cardioversion, 9 and the ratio of the RA volume index to the LA volume index is a risk factor for AF recurrence 10 . However, it is unclear to what extent RA contributes to the ablation outcome in the general population with AF.…”

Section: Introductionmentioning

confidence: 99%

Impact of right atrial structural remodeling on recurrence after ablation for atrial fibrillation

Takagi

Nakamura

Asami

et al. 2021

Journal of Arrhythmia

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Background Recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is associated with left atrial (LA) remodeling; however, its association with right atrial (RA) remodeling remains unclear. Objective This study aimed to identify whether RA structural remodeling could predict recurrence of AF after PVI. Methods This study prospectively analyzed 245 patients with AF who had undergone PVI. RA and LA volumes were determined by contrast‐enhanced computed tomography. Atrial structural remodeling was defined as an atrial volume of ≥110 mL according to previous reports and receiver operating characteristic curve analysis. Results After excluding 32 patients, 213 patients were analyzed. During a follow‐up period of 12 months, 41 patients (19%) demonstrated atrial arrhythmia recurrence after PVI. With the Cox proportional‐hazards model, RA structural remodeling was the only predictor of arrhythmia recurrence (hazard ratio, 1.012; 95% confidence interval 1.003‐1.021; P = .009). Kaplan–Meier analysis showed that arrhythmia recurrence was more frequent in the RA structural remodeling group compared with the group without RA remodeling (log‐rank, P < .001), and the arrhythmia‐free survival rates in these groups at 12 months were 68.0% and 91.4%, respectively. Additionally, there was a significant difference in recurrence‐free survival after RA structural remodeling in each type of AF (log‐rank, P < .001). Conclusions RA structural remodeling is a useful predictor of clinical outcome after PVI regardless of the type of AF. Our results suggest that patients without RA structural remodeling may be good candidates for successful ablation with PVI.

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“…A JPVI és BPVI monalis vénaizoláción átesett betegekben (34). A JPVI miatt operált betegekben a szupraventrikuláris aritmiák prediktorának bizonyult (35).…”

Section: A Jobb Pitvar Méretének Klinikai Jelentőségeunclassified

A jobb pitvari méret és funkció noninvazív vizsgálatának módszerei és jelentőségük

Nógrádi¹,

Faludi²

2020

Cardiologia Hungarica

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A szív képalkotó vizsgálatai hagyományosan a bal kamrára összpontosítottak, majd az utóbbi évtizedekben a bal pit-gálható a szívüregek közül utolsóként a jobb pitvar is. A pitvarméretek egy-majd kétdimenziós vizsgálata után ma már tak. A jobb pitvari morfológia és funkció részleteinek megismerése új adatokkal gazdagíthatja a diagnosztikát, valamint a rizikó és a prognózis becslését.The traditional target of the cardiovascular imaging was the left ventricle. In the last decades the left atrium and the right heart also gained importance. The development of new imaging modalities such as modern echocardiographic techniques, cardiac CT and MRI made it possible to acquire more exact and detailed knowledge of the right atrium, as the last cardiac chamber to be investigated. After the one-and two-dimensional evaluation of the right atrial size, assessment of the phases of right atrial function, providing more information on early functional impairment and compensatory mechanisms. The detailed knowledge of right atrial morphology and function allows for more exact diagnosis, risk assessment and prognostic evaluation. BevezetésRégen elmúlt már az a korszak, amikor a jobb szívfél ben. Napjainkban a jobb kamra (1, 2) mellett a jobb rek -modern echokardiográfiás technikák, CT, MRsegítségével egyre több diagnosztikus és prognosztiis.-ták, és ezek az adatok nagymértékben hozzájárultak a balszívfél-elégtelenség patofiziológiájának megértésépárhuzamosan egyre több adat áll rendelkezésre a JP-i mechanikával kapcsolatban is, amelyek figyelmet érdemelnek. Így jelen munkánk célja, hogy áttekintsük a JP-i méret-és funkció vizsgálatára szolgáló noninvazív kép-

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The Right to Left Atrial Volume Ratio Predicts Outcomes after Circumferential Pulmonary Vein Isolation of Longstanding Persistent Atrial Fibrillation

Cited by 12 publications

References 29 publications

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

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

Impact of right atrial structural remodeling on recurrence after ablation for atrial fibrillation

A jobb pitvari méret és funkció noninvazív vizsgálatának módszerei és jelentőségük

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