SPC365

Left atrial volume predicts major adverse cardiac events after catheter ablation for atrial fibrillation

Session: Sessão de Posters 03 - Arritmias cardíacas e dispositivos percutâneos no risco cardioembólico
Speaker: Rafael Silva Teixeira

Congress: CPC 2024
Topic: C. Arrhythmias and Device Therapy
Theme: 09. Device Therapy
Subtheme: 09.6 Device Therapy - Other
Session Type: Cartazes
FP Number: ---
Authors: Rafael Silva Teixeira; Marta Catarina Almeida; Inês Rodrigues; Andre Lobo; Fábio Nunes; João Almeida; Paulo Fonseca; Inês Neves; Helena Gonçalves; Marco Oliveira; João Primo; Ricardo Fontes-Carvalho

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Introduction:</span></span></span></strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">&nbsp; Atrial fibrillation (AF) is linked with significant mortality and morbidity, imposing a considerable burden on both patients and healthcare systems. Recent studies suggest that early rhythm-control therapy reduces the risk of major adverse cardiovascular events (MACE) compared to standard care in selected patients with early AF. While left atrial dilation has been associated with the clinical recurrence of AF and time to first recurrence post-ablation, this metric lacks direct clinical implications, failing to address the association between AF ablation outcomes and more severe clinical endpoints, such as all-cause mortality, stroke risk, cardiovascular mortality, or hospitalization.</span></span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Aim:</span></span></span></strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> This study aimed to evaluate the prognostic significance of Left Atrial Volume Index (LAVI) in predicting MACE following pulmonary vein isolation (PVI).</span></span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Methods:</span></span></span></strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> We conducted a retrospective analysis of patients with symptomatic AF who underwent PVI at our center. LAVI was measured using transthoracic echocardiography (TTE) prior to AF ablation. The primary endpoint was the time to first MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and acute heart failure necessitating hospitalization) after AF ablation. The secondary outcome was the time to the first documented recurrence of atrial arrhythmias.</span></span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Results:</span></span></span></strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> The study included 730 consecutive patients with symptomatic AF (470 male; mean age 58 &plusmn; 11 years). Most patients (74%, N=542) presented with paroxysmal AF. The mean indexed LA volume was 39 &plusmn; 17 ml/m&sup2;. Over a follow-up period of 1.7 &plusmn; 1.2 years, 202 recurrences and 17 MACE were observed. LAVI was significantly associated with MACE (Hazard Ratio [HR]: 1.44 for each 10 ml/m&sup2; increase; 95% Confidence Interval [CI]: 1.02-2.02; p=0.039). Furthermore, each two-fold increase in LAVI was associated with a 41% increase in the risk of early recurrence of AF (HR of 1.41; 95% CI: 1.00-1.98; p=0.048).</span></span></span></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusion:</span></span></span></strong><span style="font-size:13.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> Beyond its predictive value for AF recurrence, TTE-derived LAVI is a potentially valuable indicator for anticipating MACE following AF ablation.</span></span></span></span></span></span></p>