Left atrial shape predicts recurrence after atrial fibrillation catheter ablation.
Abstract: Introduction: Multiple markers left atrium (LA) remodeling, including LA shape, correlate with outcomes in atrial fibrillation (AF). Catheter ablation is an important treatment of AF, but better tools are needed to determine which patients will benefit. In this study, we use particle‐based...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 29; no. 7; pp. 966 - 973 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130548009&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130548009 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jul2018 vid: 29 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 130548009 130548009 130548009 10.1111/jce.13641 130548009 ppf: 966 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Left atrial shape predicts recurrence after atrial fibrillation catheter ablation. aug: au: Bieging, Erik T. Morris, Alan Wilson, Brent D. McGann, Christopher J. Marrouche, Nassir F. Cates, Joshua affil: Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA sug: subj: Atrial Fibrillation Surgery Catheter Ablation Heart Atrium, Left Pathology Recurrence Risk Factors Ventricular Remodeling Human Quantitative Studies Magnetic Resonance Imaging Methods Atrial Fibrillation Diagnosis Factor Analysis Cox Proportional Hazards Model Regression Fibrosis Data Analysis, Statistical Patient Selection ab: Abstract: Introduction: Multiple markers left atrium (LA) remodeling, including LA shape, correlate with outcomes in atrial fibrillation (AF). Catheter ablation is an important treatment of AF, but better tools are needed to determine which patients will benefit. In this study, we use particle‐based modeling to quantitatively assess LA shape, and determine to what degree it predicts AF recurrence after catheter ablation. Methods and results: There were 254 patients enrolled in the DECAAF study who underwent cardiac magnetic resonance imaging of the LA prior to AF ablation and were followed for recurrence for up to 475 days. We performed particle‐based shape modeling on each patient's LA shape. We selected shape parameters using the LASSO method and factor analysis, and then added them to a Cox regression model, which included multiple clinical parameters and LA fibrosis. We computed Harrell's C‐statistic with and without shape in the model. We used the model to stratify patients into recurrence risk classes by both shape and shape and fibrosis combined. Three shape parameters were selected for inclusion. The C‐statistic increased from 0.68 to 0.72 when shape was added to the model (P < 0.05). Visualized shapes showed that a more round LA shape with a shorter, more laterally rotated appendage was predictive of recurrence. Conclusion: LA shape is an independent predictor of recurrence after AF ablation. When combined with LA fibrosis, shape analysis using PBM may improve patient selection for ablation. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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