Effect of Left Atrial Function Index on Late Atrial Fibrillation Recurrence after Pulmonary Vein Isolation
Authors
Sardana, MayankAsamoah, Owusu
Stokken, Glenn
Spring, Matthew
Shaikh, Amir Y.
Ogunsua, Adedotun
Hansra, Barinder
Mohamud, Deego
Gagnier, Michael
Aldrugh, Summer
Esa, Nada
Floyd, Kevin C.
Browning, Clifford
Ennis, Cynthia
Donahue, Kevin
Rosenthal, Lawrence S.
Aurigemma, Gerard P.
McManus, David D.
Document Type
Poster AbstractPublication Date
2016-05-20Keywords
atrial functionpulmonary vein isolation
catheter ablation
echocardiograms
Cardiology
Cardiovascular Diseases
Health Services Administration
Surgical Procedures, Operative
Metadata
Show full item recordAbstract
Background: Although the rates of catheter ablation (CA) for atrial fibrillation (AF) are rapidly increasing, there are few predictors of outcome to help inform appropriate patient selection for this procedure. Traditional echocardiographic measures of atrial structure do not significantly reclassify risk of AF recurrence over and above the clinical risk factors. Left Atrial Function Index (LAFI) is a rhythm-independent measure of atrial function. We hypothesized that baseline LAFI would relate to AF recurrence after CA. Methods: Pre-procedural echocardiograms from 170 participants, who underwent CA for AF and were enrolled in the UMMC AF Treatment Registry, were analyzed. LAFI was calculated by a previously validated formula. Primary outcome was late or clinically significant AF recurrence 3-12 months after CA. Baseline clinical, laboratory and echocardiographic variables were compared between the recurrence and non-recurrence groups. Results: Study participants were middle aged (60+/10 years) and had a moderate-to-severe burden of cardiovascular comorbidities. 78 participants (46%) experienced late AF recurrence. Mean LAFI was 0.26+/-0.18. In multivariate analysis, lower LAFI was independently associated with the risk of recurrence (0.23 in recurrence group vs 0.29 in non-recurrence group, p < 0.01). Predictive value of LAFI for AF recurrence was similar to CHADS2 score (c-statistic 0.60 vs 0.58, p 0.76). In subgroup of patients with persistent AF, LAFI predicted AF recurrence more strongly than CHADS2 score (c-statistic: 0.79 vs 0.58, p 0.02). Conclusions: In our cohort of 170 participants with AF undergoing index CA ablation, we observed that LAFI related to late AF recurrence after CA, independent of the traditional risk factors. Since LAFI can be calculated from almost any traditional echocardiographic recording, our findings suggest that LAFI may help guide therapeutic decision-making regarding application of CA, particularly among challenging patients with symptomatic persistent AF.DOI
10.13028/b019-qb11Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28111Rights
Copyright the Author(s)Distribution License
http://creativecommons.org/licenses/by-nc-sa/3.0/ae974a485f413a2113503eed53cd6c53
10.13028/b019-qb11