title: Association between left and right atrial remodeling with atrial fibrillation recurrence after pulmonary vein catheter ablation in patients with paroxysmal atrial fibrillation: a pilot study.
abstract: BACKGROUND
  Left atrial (LA) remodeling is a factor in atrial fibrillation (AF) recurrence after pulmonary vein catheter ablation (CA), but right atrium (RA) remodeling has not been investigated for possible associations to AF recurrence.
  
  
  RESULTS
  Using 64-slice multidetector computed tomography, RA and LA volumes were measured 3-dimensionally before CA in 65 patients with initially proven idiopathic paroxysmal AF (mean age, 60±10 years, 81.5% men). The CA procedure was guided by CARTO Merge atrial electroanatomic mapping. Sixteen patients (24.6%) had AF recurrence within the 6-month period after the CA. The recurrence was associated with a large RA volume [odds ratio, 1.04; 95% confidence interval (CI), 1.02 to 1.07, P<0.0001], a large LA volume with 1.04 [95% CI, 1.01 to 1.06, P=0.002], and low LA mean voltage with 1.03 [95% CI, 1.01 to 1.05, P=0.002]. After adjustment for potential confounding variables, RA and LA volumes remained predictive of AF recurrence. Large atrial volumes (mL) (RA ≥87 or LA ≥99) predicted AF recurrence (sensitivity of RA volume: 81.3% in 13 of 16 patients with AF recurrence; specificity: 75.5% in 37 of 49 patients without AF recurrence; sensitivity of LA volume: 81.3% in 13 of 16 patients with AF recurrence; specificity: 69.4% in 34 of 49 patients without AF recurrence), and the combined estimate of both atrial volumes was incremental and additive prognostic power (sensitivity: 75% in 12 of 16 patients with AF recurrence; specificity: 93.9% in 46 of 49 patients without AF recurrence).
  
  
  CONCLUSIONS
  Both LA and RA remodeling are equally associated with post-CA AF recurrence.
authors.affiliation: Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. hzn01233@s02.itscom.net
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Kyouichi
authors.initials: K
authors.lastname: Kaneko
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kodama
authors.forename: Jumpei
authors.initials: J
authors.lastname: Suyama
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Li
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hamazaki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tanno
authors.forename: Takehiko
authors.initials: T
authors.lastname: Gokan
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D016279:Atrial Function, Left / Q000502:physiology*; D016280:Atrial Function, Right / Q000502:physiology*; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D013614:Tachycardia, Paroxysmal / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed