Background: The role of the right atrium (RA) after radiofrequency ablation (RFA) of atrial fibrillation (AF) is relatively unclear when compared to the left atrium (LA). We investigated the impact of RA anatomical remodeling on outcomes of nonvalvular AF after RFA.
Methods: Sixty-three patients (50 men, 57±10 yrs, 23 persistent AF [PeAF]) who underwent RFA for AF were enrolled. Both right and left atrial volumes, measured with multidetector computed tomography and indexed to each patient’s body surface area, as well as echocardiographic parameters and electrophysiological characteristics were compared between subjects with early (<3 months, n=13) or 1-year (n=19) recurrence after RFA and without recurrence.
Results: RA volume index (RAVI) was larger (98±21 vs. 77±22 ml/m2) and PeAF was more common (62% vs. 30%) in patients with early recurrence (P<0.05 for all), whereas LA volume index (LAVI) was similar between two groups (78±15 vs. 72±19 ml/m2, P=0.23). Notably, RAVI was the only independent predictor of early recurrence (for each 10 ml/m2 increase, OR: 1.650, 95% CI: 1.017-2.677, P=0.04). Concurrently, RAVI (91±27 vs. 77±20 ml/m2) and LAVI (80±18 vs. 70±17 ml/m2) were larger and PeAF was more common (63% vs. 25%) in patients with 1-year recurrence after RFA (P<0.05 for all). However, PeAF was the only independent predictor of 1-year recurrence after RFA (OR: 4.496, 95% CI: 1.110-18.211, P=0.04), whereas RAVI and LAVI were not.
Conclusion: RA anatomical remodeling may affect early recurrence after RFA of AF. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence after RFA of AF.
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