Association of left atrial enlargement and increased left ventricular wall thickness with arrhythmia recurrence after cryoballoon ablation for atrial fibrillation
Authors:
- Grzegorz Warmiński,
- Piotr Urbanek,
- Michał Orczykowski,
- Robert Bodalski,
- Łukasz Kalińczuk,
- Kamil Zieliński,
- Gary S Mintz,
- Zbigniew Jedynak,
- Andrzej Hasiec,
- Joanna Zakrzewska-Koperska,
- Ilona Michałowska,
- Ilona Kowalik,
- Hubert Łazarczyk,
- Maciej Sterliński,
- Maria Bilińska,
- Paweł Pławiak,
- Łukasz Szumowski
Abstract
Background: Left atrial enlargement (LAE) predicts atrial fibrillation (AF) recurrence after cryoballoon-based pulmonary vein isolation (CB). Increased left ventricular wall thickness (increased LVWT) is pathophysiologically associated with LAE and atrial arrhythmias. Aims: To assess effect of increased LVWT on long-term outcomes of CB depending on coexistence of LAE. Methods: LAE was defined using either echocardiography (>48 cm3/m2) or multislice computer tomography (MSCT, ≥63 cm3/m2). Increased LVWT was echocardiographic septal/posterior wall thickness >10 mm in male and >9 mm in female. All patients accomplished 2-year follow-up. Results: Of 250 patients (median age 61 years [IQR: 49.0–67.3]; 30% female) with AF (40% non-paroxysmal), 66.5% had hypertension and 27.2% underwent redo procedure. MSCT was done in 76%. During follow-up of 24.5 months (interquartile range [IQR]: 6.0–31.00) the clinical success was 72%, despite 46% of patients having arrhythmia recurrence. Arrhythmia recurrence risk was increased by LAE and increased LVWT (hazard ratio [HR] = 1.801, P = 0.002 and HR = 1.495, P = 0.036; respectively). The highest arrhythmia recurrence (61.9% at 2-years) was among patients with LAE and increased LVWT (33.6% of patients); intermediate (41.8%) among patients with isolated LAE; and lowest among patients with isolated increased LVWT or patients without LAE or increased LVWT (36.8% and 35.2% respectively, P = 0.004). After adjustment for body mass index, paroxysmal AF, CHA2DS2-VASc score, clinically-significant valvular heart disease, and cardiomyopathy, patients with LAE and concomitant increased LVWT diagnosis had 1.8-times increased risk of arrhythmia recurrence (HR = 1.784, 95% confidence interval [CI], 1.017–3.130; P = 0.043). Conclusion: Joint occurrence of LAE and increased LVWT is associated with the highest rate of arrhythmia recurrence after CB for AF.
- Record ID
- CUT7190b9731e344fc6be3c9ef0f665dc4d
- Publication categories
- ;
- Author
- Journal series
- Kardiologia Polska, ISSN 0022-9032, e-ISSN 1897-4279
- Issue year
- 2022
- Vol
- 80
- No
- 11
- Pages
- 1104-1111
- Other elements of collation
- tab.; wykr.; Bibliografia (na s.) - 1110-1111; Bibliografia (liczba pozycji) - 36; Oznaczenie streszczenia - Abstr.; Data udostępnienia on-line - 2022-08-11; Numeracja w czasopiśmie - Vol. 80, No 11
- Substantive notes
- Short title: Arrhythmia recurrence after cryoballoon ablation
- Supplementary material/Additional Files (1) dostępny na stronie redakcyjnej
- Keywords in English
- arrhythmia recurrence, atrial fibrillation, catheter ablation, cryoballoon, pulmonary vein isolation
- ASJC Classification
- DOI
- DOI:10.33963/KP.a2022.0191 Opening in a new tab
- URL
- https://journals.viamedica.pl/kardiologia_polska/article/view/KP.a2022.0191 Opening in a new tab
- Language
- eng (en) English
- License
- Score (nominal)
- 100
- Score source
- journalList
- Score
- Publication indicators
- Citation count
- 3
- Additional fields
- Indeksowana w: Web of Science, Scopus
- Uniform Resource Identifier
- https://cris.pk.edu.pl/info/article/CUT7190b9731e344fc6be3c9ef0f665dc4d/
- URN
urn:pkr-prod:CUT7190b9731e344fc6be3c9ef0f665dc4d
* presented citation count is obtained through Internet information analysis, and it is close to the number calculated by the Publish or PerishOpening in a new tab system.