title: Left Atrial Size and Left Ventricular End-Systolic Dimension Predict the Progression of Paroxysmal Atrial Fibrillation After Catheter Ablation.
abstract: Although rare, some paroxysmal atrial fibrillations (AF) still progress despite radiofrequency (RF) ablation. In the study, we evaluated the long-term efficacy of RF ablation and the predictors of AF progression.
  
  
  
  A total of 589 paroxysmal AF patients (404 men and 185 women; aged 54 ± 12 years) who received 3-dimensional mapping and ablation were enrolled. Their clinical parameters and electrophysiological characteristics were collected. They were divided into Group 1 (N = 13, with AF progression) and Group 2 (N = 576, no AF progression). AF progression was defined as recurrence of persistent AF.
  
  
  
  Group 1 patients had larger left atrial (LA) diameter, larger left ventricle (LV) end-systolic and end-diastolic diameters, poorer LV systolic function, and more amiodarone use at baseline. After 1.2 ± 0.5 procedures, 123 (21%) patients experienced recurrence during 56 ± 29 months' follow-up. In the multivariate analysis, LA diameter (P = 0.018, HR = 1.12, 95% CI = 1.02-1.24) and LV end-systolic diameter (P = 0.005, HR = 1.10, 95% CI = 1.03-1.17) independently predicted AF progression. LA diameter >43 mm and LV end-systolic diameter >31 mm were the best cut-off values for predicting AF progression by ROC analysis. AF progression rate achieved 19% if they had both larger LA diameter (>43 mm) and LV end-systolic diameter (>31 mm).
  
  
  
  RF ablation prevents the progression of paroxysmal AF effectively, except in patients with increased LA diameter and LV end-systolic diameter on echocardiogram, suggesting more aggressive rhythm control therapies should be considered in these patients.
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Ying-Chieh
authors: YC
authors: Liao
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Jo-Nan
authors: JN
authors: Liao
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Li-Wei
authors: LW
authors: Lo
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yenn-Jiang
authors: YJ
authors: Lin
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Shih-Lin
authors: SL
authors: Chang
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yu-Feng
authors: YF
authors: Hu
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Tze-Fan
authors: TF
authors: Chao
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Fa-Po
authors: FP
authors: Chung
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Ta-Chuan
authors: TC
authors: Tuan
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Abigail Louise D
authors: AL
authors: Te
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Rohit
authors: R
authors: Walia
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Shinya
authors: S
authors: Yamada
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chung-Hsing
authors: CH
authors: Lin
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chin-Yu
authors: CY
authors: Lin
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yao-Ting
authors: YT
authors: Chang
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Suresh
authors: S
authors: Allamsetty
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Wen-Chung
authors: WC
authors: Yu
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Jing-Long
authors: JL
authors: Huang
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Tsu-Juey
authors: TJ
authors: Wu
authors: Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Shih-Ann
authors: SA
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D017115:Catheter Ablation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D018450:Disease Progression; D004452:Echocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: ablation; atrial fibrillation; left atrial size; predictor; progression