BACKGROUND: Although indexed left atrial volume (iLAV) is the most accurate measure of left atrial size, it has not been evaluated prospectively as predictor of recurrence of atrial fibrillation (AFib) after successful cardioversion (CV). METHODS: We prospectively selected 76 patients (mean age 66.1 ± 13.6 years, 65.8% men) with AFib who underwent successful CV. Baseline clinical and echocardiographic characteristics were obtained before CV. LAV was measured using Simpson's method and indexed to body surface area. All patients were scheduled for follow-up visit at 1, 6, 12 months, and then annually. A 24-hour Holter ECG was performed within 6 months and each time the patients reported symptoms suggestive of arrhythmia. RESULTS: The 52 patients (68.4%) with AFib recurrence had larger iLAV (35.5 ± 8.9 mL/m(2) vs 27.0 ± 6.7 mL/m(2) , P < 0.001). Anteroposterior LA diameter was not associated with AFib relapse (OR 1.08, 95% CI: 0.96-1.21, P = 0.09). Each unit increase in iLAV was associated with a 1.15-fold increased risk of recurrence (OR 1.15, 95% CI: 1.06-1.25, P < 0.001). In a multivariable model, iLAV remained the only independent predictor of relapse (adjusted OR 1.14, 95% CI: 1.02-1.28, P = 0.02). The area under ROC curves, generated to compare LA diameter, and iLAV as predictors of AFib recurrence were 0.56 (SE 0.07) versus 0.78 (SE 0.05), respectively (P = 0.003). CONCLUSION: This is the first prospective study to show that larger iLAV, as a more accurate measure of LA remodeling than anteroposterior diameter, is strongly and independently associated with a higher risk of AFib recurrence after CV.

Indexed left atrial volume is superior to left atrial diameter in predicting nonvalvular atrial fibrillation recurrence after successful cardioversion: a prospective study / Marchese, P; Malavasi, V; Rossi, L; Nikolskaya, N; Donne, Gd; Becirovic, M; Colantoni, A; Luciani, A; Modena, Maria Grazia. - In: ECHOCARDIOGRAPHY. - ISSN 0742-2822. - ELETTRONICO. - 29:(2012), pp. 276-284. [10.1111/j.1540-8175.2011.01580.x]

Indexed left atrial volume is superior to left atrial diameter in predicting nonvalvular atrial fibrillation recurrence after successful cardioversion: a prospective study.

MODENA, Maria Grazia
2012

Abstract

BACKGROUND: Although indexed left atrial volume (iLAV) is the most accurate measure of left atrial size, it has not been evaluated prospectively as predictor of recurrence of atrial fibrillation (AFib) after successful cardioversion (CV). METHODS: We prospectively selected 76 patients (mean age 66.1 ± 13.6 years, 65.8% men) with AFib who underwent successful CV. Baseline clinical and echocardiographic characteristics were obtained before CV. LAV was measured using Simpson's method and indexed to body surface area. All patients were scheduled for follow-up visit at 1, 6, 12 months, and then annually. A 24-hour Holter ECG was performed within 6 months and each time the patients reported symptoms suggestive of arrhythmia. RESULTS: The 52 patients (68.4%) with AFib recurrence had larger iLAV (35.5 ± 8.9 mL/m(2) vs 27.0 ± 6.7 mL/m(2) , P < 0.001). Anteroposterior LA diameter was not associated with AFib relapse (OR 1.08, 95% CI: 0.96-1.21, P = 0.09). Each unit increase in iLAV was associated with a 1.15-fold increased risk of recurrence (OR 1.15, 95% CI: 1.06-1.25, P < 0.001). In a multivariable model, iLAV remained the only independent predictor of relapse (adjusted OR 1.14, 95% CI: 1.02-1.28, P = 0.02). The area under ROC curves, generated to compare LA diameter, and iLAV as predictors of AFib recurrence were 0.56 (SE 0.07) versus 0.78 (SE 0.05), respectively (P = 0.003). CONCLUSION: This is the first prospective study to show that larger iLAV, as a more accurate measure of LA remodeling than anteroposterior diameter, is strongly and independently associated with a higher risk of AFib recurrence after CV.
2012
29
276
284
Indexed left atrial volume is superior to left atrial diameter in predicting nonvalvular atrial fibrillation recurrence after successful cardioversion: a prospective study / Marchese, P; Malavasi, V; Rossi, L; Nikolskaya, N; Donne, Gd; Becirovic, M; Colantoni, A; Luciani, A; Modena, Maria Grazia. - In: ECHOCARDIOGRAPHY. - ISSN 0742-2822. - ELETTRONICO. - 29:(2012), pp. 276-284. [10.1111/j.1540-8175.2011.01580.x]
Marchese, P; Malavasi, V; Rossi, L; Nikolskaya, N; Donne, Gd; Becirovic, M; Colantoni, A; Luciani, A; Modena, Maria Grazia
File in questo prodotto:
File Dimensione Formato  
Marchese_et_al-2012-Echocardiography.pdf

Open access

Tipologia: Versione pubblicata dall'editore
Dimensione 569.57 kB
Formato Adobe PDF
569.57 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/794489
Citazioni
  • ???jsp.display-item.citation.pmc??? 14
  • Scopus 50
  • ???jsp.display-item.citation.isi??? 47
social impact