Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation.
10.3904/kjim.2015.30.6.808
- Author:
Hong Euy LIM
1
;
Jin Oh NA
;
Sung Il IM
;
Cheol Ung CHOI
;
Seong Hwan KIM
;
Jin Won KIM
;
Eung Ju KIM
;
Seong Woo HAN
;
Seung Woon RHA
;
Chang Gyu PARK
;
Hong Seog SEO
;
Dong Joo OH
;
Chun HWANG
Author Information
1. Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea. jinona@medimail.co.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Atrial fibrillation;
Atrial septum;
Heart atria;
Atrial remodeling
- MeSH:
Action Potentials;
Adult;
Aged;
Area Under Curve;
Atrial Fibrillation/physiopathology/*radiography/surgery/*ultrasonography;
*Atrial Function, Left;
*Atrial Remodeling;
Atrial Septum/physiopathology/*radiography/*ultrasonography;
Catheter Ablation;
Chi-Square Distribution;
*Echocardiography, Doppler;
Electrophysiologic Techniques, Cardiac;
Female;
Humans;
Linear Models;
Male;
Middle Aged;
*Multidetector Computed Tomography;
Multivariate Analysis;
Predictive Value of Tests;
Prospective Studies;
ROC Curve;
Recurrence;
Risk Factors;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2015;30(6):808-820
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. METHODS: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. RESULTS: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEFtotal; r = -0.213, p = 0.030), and active LAEF (LAEFactive; r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (> or = 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. CONCLUSIONS: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.
