title: Pre-procedural prediction of termination of persistent atrial fibrillation by catheter ablation as an indicator of reverse remodeling of the left atrium.
abstract: BACKGROUND
  The pre-procedural prediction of atrial fibrillation (AF) termination by catheter ablation in patients with persistent AF has not been evaluated fully. The aim of this study was to evaluate the pre-procedural predictors of persistent AF termination by ablation associated with the possibility of reverse remodeling of the left atrium (LA).
  
  
  RESULTS
  Seventy consecutive patients (mean age, 62±8 years) with persistent or long-standing persistent AF underwent ablation. They were divided into 2 groups: those with AF terminated by ablation (n=14; group 1) and those with AF terminated by cardioversion after ablation (n=56; group 2). The left atrial appendage (LAA) contraction velocity determined on transesophageal echocardiography was significantly decreased in group 2 as compared to group 1 (P<0.001). Kaplan-Meier analysis showed that the group 1 patients had a higher AF-free survival rate than those in group 2 during 12±4.1 months of follow-up (P=0.048). The LA reverse remodeling ratio, given as the volume difference between before and 3 months after ablation in group 1, was significantly greater after ablation than that in group 2 (25.8±13% vs. 15.0±15%, P=0.015). Multivariate logistic regression analysis indicated that the LAA contraction velocity was an independent predictor of persistent AF termination by ablation (P=0.018).
  
  
  CONCLUSIONS
  The LAA contraction velocity was the only non-invasive pre-procedural predictor of persistent AF termination by ablation, indicating the possibility of reverse remodeling of the LA.
authors: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi 371-0004, Japan. kkumagai4917@yahoo.co.jp
authors: Koji
authors: K
authors: Kumagai
authors: Tamotsu
authors: T
authors: Sakamoto
authors: Keijiro
authors: K
authors: Nakamura
authors: Mamoru
authors: M
authors: Hayano
authors: Eiji
authors: E
authors: Yamashita
authors: Shigeru
authors: S
authors: Oshima
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D064752:Atrial Remodeling; D017115:Catheter Ablation; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction