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Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

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Abstract

Purpose

Although left atrial function index is reportedly a possible predictor of hospitalization for heart failure and of stroke irrespective of the presence or not of atrial fibrillation (AF), the effects of catheter ablation on left atrial function index have not yet been reported.

Methods

We performed catheter ablation on 55 patients (age 56.6 ± 9.6 years; 44 men; 30 with paroxysmal and 25 with persistent, long-standing AF) and evaluated them by transthoracic echocardiography preoperatively and 3 monthly for 12–24 months after catheter ablation. We then compared clinical characteristics and echocardiographic variables before catheter ablation between two groups: the 42 subjects with the most recent left atrial function index <30 and the 13 in which it was ≥30.

Results

Left atrial function index improved after catheter ablation in both groups, plateauing 6 months after the procedure. Univariate analysis showed statistically significant differences in the prevalence of chronic AF and left atrial emptying fraction, diameter, and maximum and minimum volume (prevalence of chronic AF, p < 0.05; others, p < 0.01) between the groups. Multivariate analysis showed that only maximum left atrial volume predicts left atrial function index after catheter ablation (p < 0.05). In addition, we used ROC analysis to calculate a cutoff value for LA maximum volume as a good predictor and found that a good cutoff value was 63.5 mL, the sensitivity and specificity being 0.75 and 0.75, respectively.

Conclusions

Catheter ablation improves left atrial function index. However, in patients with left atrial maximum volume of over 63.5 mL on echocardiography, the index did not recover to within the normal range after catheter ablation.

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Abbreviations

AF:

Atrial fibrillation

AFL:

Atrial flutter

AT:

Atrial tachycardia

BSA:

Body surface area

CA:

Catheter ablation

CAF:

Persistent or long-standing persistent AF

CFAE:

Complex fragmented atrial electrogram

CHD:

Coronary heart disease

CT:

Computed tomography

ILVT:

Idiopathic left ventricular tachycardia

IRB:

Institutional review board

LA:

Left atrium

LAA:

Left atrial appendage

LAEF:

Left atrial emptying fraction

LAESV:

Maximum left atrial volume in end systole = LA end systolic volume

LAFI:

Left atrial function index

LA maximum volume:

Left atrial maximum volume = LA end systolic volume

LA minimum volume:

Left atrial minimum volume = LA end diastolic volume

LAFI:

Left atrial function index

LVEF:

Left ventricular ejection fraction

LVOT VTI:

Left ventricular outflow tract velocity-time integral

PSVT:

Paroxysmal supraventricular tachycardia

PV:

Pulmonary vein

PVI:

Pulmonary vein isolation

SD:

Standard deviation

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

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Acknowledgments

R Kato supervised research design and details. S Nakano revised statistical analysis of data. S Iwanaga confirmed whether all echocardiographic assessment was properly performed. Y Shiki, S Tanaka, and Y Ikeda cooperated in collecting data. S Nishimura and K Matsumoto approved this article.

Conflict of interest

The authors declare that they have no conflict of interest. All authors do not have any financial support.

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Authors and Affiliations

  1. Department of Cardiology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Takahiko Nagase, Ritsushi Kato, Shintaro Nakano, Yuichirou Shiki, Sayaka Tanaka, Yoshifumi Ikeda, Shiro Iwanaga, Shigeyuki Nishimura & Kazuo Matsumoto

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  1. Takahiko Nagase
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  2. Ritsushi Kato
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Correspondence to Ritsushi Kato.

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Nagase, T., Kato, R., Nakano, S. et al. Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation. J Interv Card Electrophysiol 44, 151–160 (2015). https://doi.org/10.1007/s10840-015-0043-z

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  • DOI: https://doi.org/10.1007/s10840-015-0043-z

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