The predictive value of cardiac morphology for long-term outcome of patients undergoing catheter ablation for atrial fibrillation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10381938" target="_blank" >RIV/00216208:11110/18:10381938 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064165:_____/18:10381938

Výsledek na webu

<a href="https://doi.org/10.1016/j.jcct.2018.06.005" target="_blank" >https://doi.org/10.1016/j.jcct.2018.06.005</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jcct.2018.06.005" target="_blank" >10.1016/j.jcct.2018.06.005</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The predictive value of cardiac morphology for long-term outcome of patients undergoing catheter ablation for atrial fibrillation

Popis výsledku v původním jazyce

Objective: Catheter ablation (CA) is an established therapy for selected patients with atrial fibrillation (AF), but predictors of CA ablation outcome are still not fully elucidated. The aim of the study was to identify structural and morphological parameters from computed tomography (CT) as predictors of successful CA of AF in a single center prospective cohort. Methods: An analysis of CT scans dedicated to LA evaluation was performed in 99 patients (63 +/- 8 years old, 70% males, 59% paroxysmal AF) scheduled for CA of AF. Survival free of atrial fibrillation/flutter/tachycardia at 1- and 3-years was assessed. Results: In overall study population, both 1- and 3-year responders had smaller distance to the first division in left superior pulmonary vein (16.3 +/- 5.42 mm vs. 19.1 +/- 7.0 mm and 14.9 +/- 3.6 mm vs. 18.7 +/- 7.0 mm; p &lt; 0.05). One-year responders had larger ostium area of left inferior pulmonary vein (median 236 mm(2) [IQR = 97] vs. 222 mm(2) [IQR = 71]; p = 0.03) and less acute angle between the interatrial septum and the right superior pulmonary vein (102 +/- 20 degrees vs. 95 +/- 10 degrees; p = 0.03). Three-years&apos; responders had smaller ostium area of the right superior pulmonary vein (248 +/- 94 mm(2) vs. 364 +/- 282 mm(2); p = 0.02). Multivariate Cox regression analysis identified different predictors in paroxysmal and non-paroxysmal AF. For patients with paroxysmal AF, the predictors were angle to right superior pulmonary vein and left superior/inferior pulmonary veins carina thickness with hazard ratios of 0.965 (95%CI 0.939 to 0.992, p = 0.010) and 0.747 (95% CI 0.591 to 0.944, p = 0.015). In patients with persistent AF, the predictors were gender and NYHA stage with hazard ratios of 4.9 (95%CI 1.758 to 13.579, p = 0.002) and 0.365 (95%CI 0.148 to 0.899, p = 0.028) respectively. Conclusions: The anatomy of LA, especially morphology of pulmonary veins, seems to be one of the predictors of clinical outcome after CA for paroxysmal AF. In non-paroxysmal AF LA anatomy is less relevant in prediction of clinical outcome.

Název v anglickém jazyce

The predictive value of cardiac morphology for long-term outcome of patients undergoing catheter ablation for atrial fibrillation

Popis výsledku anglicky

Objective: Catheter ablation (CA) is an established therapy for selected patients with atrial fibrillation (AF), but predictors of CA ablation outcome are still not fully elucidated. The aim of the study was to identify structural and morphological parameters from computed tomography (CT) as predictors of successful CA of AF in a single center prospective cohort. Methods: An analysis of CT scans dedicated to LA evaluation was performed in 99 patients (63 +/- 8 years old, 70% males, 59% paroxysmal AF) scheduled for CA of AF. Survival free of atrial fibrillation/flutter/tachycardia at 1- and 3-years was assessed. Results: In overall study population, both 1- and 3-year responders had smaller distance to the first division in left superior pulmonary vein (16.3 +/- 5.42 mm vs. 19.1 +/- 7.0 mm and 14.9 +/- 3.6 mm vs. 18.7 +/- 7.0 mm; p &lt; 0.05). One-year responders had larger ostium area of left inferior pulmonary vein (median 236 mm(2) [IQR = 97] vs. 222 mm(2) [IQR = 71]; p = 0.03) and less acute angle between the interatrial septum and the right superior pulmonary vein (102 +/- 20 degrees vs. 95 +/- 10 degrees; p = 0.03). Three-years&apos; responders had smaller ostium area of the right superior pulmonary vein (248 +/- 94 mm(2) vs. 364 +/- 282 mm(2); p = 0.02). Multivariate Cox regression analysis identified different predictors in paroxysmal and non-paroxysmal AF. For patients with paroxysmal AF, the predictors were angle to right superior pulmonary vein and left superior/inferior pulmonary veins carina thickness with hazard ratios of 0.965 (95%CI 0.939 to 0.992, p = 0.010) and 0.747 (95% CI 0.591 to 0.944, p = 0.015). In patients with persistent AF, the predictors were gender and NYHA stage with hazard ratios of 4.9 (95%CI 1.758 to 13.579, p = 0.002) and 0.365 (95%CI 0.148 to 0.899, p = 0.028) respectively. Conclusions: The anatomy of LA, especially morphology of pulmonary veins, seems to be one of the predictors of clinical outcome after CA for paroxysmal AF. In non-paroxysmal AF LA anatomy is less relevant in prediction of clinical outcome.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30224 - Radiology, nuclear medicine and medical imaging

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Cardiovascular Computed Tomography

ISSN

1934-5925

e-ISSN

—

Svazek periodika

12

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

418-424

Kód UT WoS článku

000446520200012

EID výsledku v databázi Scopus

2-s2.0-85048857859