Additional value of left atrium remodeling assessed by three-dimensional echocardiography for the prediction of atrial fibrillation recurrence after cryoballoon ablation

• Published in: The international journal of cardiovascular imaging 2022-05, Vol.38 (5), p.1103-1111
• Main Authors: Motoc, Andreea, Scheirlynck, Esther, Roosens, Bram, Luchian, Maria-Luiza, Chameleva, Hadischat, Gevers, Maxim, Galloo, Xavier, von Kemp, Berlinde, de Asmundis, Carlo, Magne, Julien, Droogmans, Steven, Cosyns, Bernard
• Format: Article
• Language: English
• Subjects: Ablation; Atria; Blanking; Cardiac arrhythmia; Cardiac Imaging; Cardiology; Complications; Diameters; Echocardiography; Fibrillation; Imaging; Medicine; Medicine & Public Health; Original Paper; Radiology
• ISSN: 1875-8312; 1569-5794; 1875-8312; 1573-0743
• DOI: 10.1007/s10554-021-02493-9

Cryoballoon ablation (CBA) is a safe and efficient therapeutic option for atrial fibrillation (AF). However, AF recurrence occurs in 25% of the patients, leading to repeated ablations and complications. Previous reports have shown that left atrium (LA) assessed by M-Mode and two-dimensional echocardiography (2DE) predicts AF recurrence. Nevertheless, these methods imply geometrical assumptions of the LA remodeling, which is a three-dimensional process. We hypothesized that LA remodeling by three-dimensional echocardiography (3DE) has an additional value for AF recurrence prediction post-CBA. 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively recruited. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period. 50 (29%) patients had AF recurrence. 3DE LA maximum volume index (LAVI) had the highest incremental predictive value for AF recurrence (HR 5.50, 95% CI 1.34 -22.45, p