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Impact of left atrial box surface ratio on the recurrence after ablation for persistent atrial fibrillation
| Content Provider | Scilit |
|---|---|
| Author | Keçe, Fehmi Scholte, Arthur J. Riva, Marta De Md, Yoshihisa Naruse Md, Masaya Watanabe Md, Reza Alizadeh Dehnavi Md, Martin J. Schalij Md, Katja Zeppenfeld Md, Serge A. Trines |
| Copyright Year | 2018 |
| Description | Journal: Pacing and Clinical Electrophysiology Background The posterior wall of the left atrium (LA) is a well‐known substrate for atrial fibrillation (AF) maintenance. Isolation of the posterior wall between the pulmonary veins (box lesion) may improve ablation success. Box lesion surface area size varies depending on the individual anatomy. This retrospective study evaluates the influence of box lesion surface area as a ratio of total LA surface area (box surface ratio) on arrhythmia recurrence. Methods Seventy consecutive patients with persistent AF (63±11 years, 53 men) undergoing CT imaging and ablation procedure consisting of a first box lesion were included in this study. Box lesion surface area was measured on electroanatomical maps and total LA surface area was derived from CT. Patients were followed with 24‐hour electrocardiography and exercise tests at 3, 6 and 12 months after AF ablation. Arrhythmia recurrence was defined as any AF/atrial tachycardia (AT) beyond 3 months without anti‐arrhythmic drugs. Results During a median follow‐up of 13 (IQR 10–17) months, 42 (60%) patients had AF/AT recurrence. Multivariate Cox proportional regression analysis showed that a larger box surface ratio protected against recurrence (Hazard Ratio (HR) 0.81; 95% confidence interval (CI) (0.690–0.955); p = 0.012). Left atrial volume index (HR 1.01 (0.990‐1.024, p = 0.427) and a history of mitral valve surgery (HR 2.90; 95% CI 0.970–8.693; p = 0.057) were not associated with AF recurrence in multivariate analysis. Conclusion A larger box lesion surface area as a ratio of total LA surface area is protective for AF/AT recurrence after ablation for persistent AF. This article is protected by copyright. All rights reserved |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850488/pdf |
| Ending Page | 215 |
| Page Count | 8 |
| Starting Page | 208 |
| ISSN | 01478389 |
| e-ISSN | 15408159 |
| DOI | 10.1111/pace.13570 |
| Journal | Pacing and Clinical Electrophysiology |
| Issue Number | 2 |
| Volume Number | 42 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2018-12-05 |
| Access Restriction | Open |
| Subject Keyword | Journal: Pacing and Clinical Electrophysiology Cardiology and Cardiovascular Diseases Catheter Ablation Left Atrial Box Lesion Persistent Atrial Fibrillation Ablation Substrate Modification |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
