title: Predictors of left atrial volume index reduction following cryoballoon-based pulmonary vein isolation.
abstract: OBJECTIVE
  Ablation for atrial fibrillation (AF) has been suggested to be associated with 'reverse left atrial remodelling'. Reduction in left atrial volume index (LAVIR) is regarded as a determinant of reverse remodelling following pulmonary vein isolation (PVI). However, there is paucity on data about the predictors for LAVIR after PVI. In this study, we aimed to investigate predictors of LAVIR at 12 months in AF patients undergoing cryoballoon-based PVI.
  
  
  RESULTS
  Patients with symptomatic paroxysmal or persistent AF despite ≥1 antiarrhythmic drug(s), who were scheduled for cryoballoon-based AF ablation procedure per the recent consensus recommendations, were enrolled and followed-up for 12 months in this prospective observational study. Left atrial volume was derived using the biplane area-length method. A total of 160 patients (54.25 ± 7.66 years, 44.40% female) were involved in the study. Reduction in left atrial volume index occurred in 120 patients. Age [hazard ratio (HR): 0.901, 95% confidence interval (CI): 0.828-0.981, P = 0.017], hypertension (HR: 0.151, 95% CI: 0.048-0.471, P = 0.001), mild mitral regurgitation (MR) (HR: 5.327, 95% CI: 1.489-19.058, P = 0.010), and AF recurrence (HR: 0.017, 95% CI: 0.005-0.065, P< 0.001) were found to be independent predictors for LAVIR.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the largest study in the literature investigating the predictors of LAVIR following AF ablation. According to this data, younger patients without hypertension or moderate MR are most likely to experience LAVIR following ablation.
authors.affiliation: Department of Cardiology, Hakkari State Hospital, Hakkari, Turkey.
authors.forename: Muhammed Ulvi
authors.initials: MU
authors.lastname: Yalcin
authors.affiliation: Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey.
authors.forename: Kadri Murat
authors.initials: KM
authors.lastname: Gurses
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey kocyigitduygu@yahoo.com.
authors.forename: Duygu
authors.initials: D
authors.lastname: Kocyigit
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Evranos
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Oto
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Necla
authors.initials: N
authors.lastname: Ozer
mesh_terms: D000367:Age Factors; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Left atrial volume index; Predictors; Reverse remodelling