EJIMA KOICHIRO
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor (Fixed Term)
Article types Original article
Language English
Peer review Peer reviewed
Title Impact of atrial remodeling on the outcome of radiofrequency catheter ablation of paroxysmal atrial fibrillation.
Journal Formal name:Circulation journal : official journal of the Japanese Circulation Society
Abbreviation:Circ J
ISSN code:13469843/13474820
Domestic / ForeginDomestic
Publisher Japanese Circulation Society
Volume, Issue, Page 78(4),872-877頁
Author and coauthor EJIMA Koichiro†*, KATO Ken, ARAI Kotaro, FUKUSHIMA Keiko, FUKUSHIMA Noritoshi, SUZUKI Tsuyoshi, YOSHIDA Kentaro, NUKI Toshiaki, UEMATSU Shoko, HOSHI Hiromi, MANAKA Tetsuyuki, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa
Publication date 2014/04
Summary BACKGROUND:
 Both the left atrial volume index (LAVI) and estimated total atrial conduction time measured using tissue Doppler imaging of the atria (PA-TDI duration) are echocardiographic parameters reflecting atrial remodeling. We investigated their prognostic value for atrial tachyarrhythmia (AF/AT) recurrence after radiofrequency catheter ablation (RFCA) of paroxysmal atrial fibrillation (PAF).

METHODS AND RESULTS:
 We analyzed the data for 100 consecutive patients with drug-refractory PAF who underwent RFCA. The correlation between the LAVI and PA-TDI was extremely weak (r=0.26, P<0.01). We categorized the patients into 4 groups based on the median LAVI and PA-TDI duration: group 1 (LAVI <29ml/m(2)/PA-TDI duration <143ms), group 2 (LAVI ≥29ml/m(2)/PA-TDI duration <143ms), group 3 (LAVI <29ml/m(2)/PA-TDI duration ≥143ms), and group 4 (LAVI ≥29ml/m(2)/PA-TDI duration ≥143ms). With a mean follow-up of 20.2±8.9 months after a single RFCA procedure, 60 patients (60%) were in sinus rhythm without any antiarrhythmic drugs. Multivariate analysis using a Cox proportional hazards model demonstrated that the group was an independent predictor of AF/AT recurrence after RFCA (P=0.0017). The patients in groups 2, 3, and 4 had a 4.0-fold (P=0.048), 6.8-fold (P=0.0034) and 10.9-fold (P=0.0001) increase, respectively, in the probability of recurrent AF/AT as compared with group 1.

CONCLUSIONS:
 Preprocedural echocardiographic estimation of atrial remodeling was a useful predictor of AF/AT recurrence following a single RFCA of PAF.
DOI 10.1253/circj.CJ-13-1391