Cardiology Division, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
Circ J. 2012;76(4):860-7. doi: 10.1253/circj.cj-11-1232. Epub 2012 Jan 31.
The impact of the right atrial (RA) anatomical remodeling on outcomes of atrial fibrillation (AF) after radiofrequency ablation (RFA) is unclear.
Sixty-three patients (50 men, 57±10 years, 23 persistent AF [PeAF]) who underwent RFA for AF were enrolled. Both RA and left atrial (LA) volumes, measured with multidetector computed tomography, as well as echocardiographic parameters were compared between subjects with early (<3 months, n=13) or 1-year (n=19) recurrence after RFA and without recurrence. The RA volume index (RAVI) was larger (98±21 vs. 77±22 ml/m²) and PeAF was more common (62% vs. 30%) in the early recurrence group (P<0.05 for all), whereas the LA volume index (LAVI) was similar between the 2 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). 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.
RA anatomical remodeling might affect the early recurrence of AF after RFA. However, the chronicity of AF, rather than RA and LA anatomical remodeling, is a determinant of 1-year recurrence of AF after RFA.
右心房（RA）解剖重构对射频消融（RFA）后房颤（AF）结局的影响尚不清楚。
共纳入 63 例（50 名男性，57±10 岁，23 例持续性房颤[PeAF]）因 AF 接受 RFA 的患者。比较 RFA 后 3 个月内（n=13）或 1 年内（n=19）复发和未复发患者的多排 CT 测量的 RA 和左心房（LA）容积以及超声心动图参数。早期复发组的 RA 容积指数（RAVI）较大（98±21 vs. 77±22 ml/m²），PeAF 更为常见（62% vs. 30%，P<0.05 均），而两组的 LA 容积指数（LAVI）相似（78±15 vs. 72±19 ml/m²，P=0.23）。值得注意的是，RAVI 是早期复发的唯一独立预测因素（每增加 10 ml/m²，OR：1.650，95%CI：1.017-2.677，P=0.04）。PeAF 是 RFA 后 1 年复发的唯一独立预测因素（OR：4.496，95%CI：1.110-18.211，P=0.04），而 RAVI 和 LAVI 则不是。
RA 解剖重构可能影响 RFA 后 AF 的早期复发。然而，AF 的慢性，而不是 RA 和 LA 解剖重构，是 RFA 后 AF 1 年复发的决定因素。
