부산대학교 도서관

Background Atrial fibrillation ( AF) is associated with atrial remodeling. We investigate the abilities of preprocedural echocardiographic parameters reflecting atrial remodeling to predict AF recurrence after radiofrequency catheter ablation ( RFCA) for paroxysmal AF ( PAF). Methods Preprocedural echocardiographic parameters were measured during sinus rhythm in 105 patients with PAF undergoing RFCA. Electrical remodeling was assessed by the time from the onset of the P-wave to the peak A′-wave on the tissue Doppler imaging ( PA- TDI), functional remodeling was assessed by the left atrial appendage flow velocity ( LAAFV), and structural remodeling was assessed by the left atrial volume index ( LAVI). PA- TDI, LAAFV, and LAVI values were divided into tertiles, and their abilities to predict AF recurrence were assessed using Cox regression analysis. Results AF recurrence occurred in 39/105 (37.1%) patients. After adjustment for confounders, the rate of AF recurrence was significantly higher in the highest tertile of PA-TDI compared with the lowest tertile (≥151.3 msec vs. <131.0 msec; hazard ratio [HR]: 2.477, 95% confidence interval [CI]: 1.031-5.950; P = 0.042), and in the lowest tertile of LAAFV compared with the highest tertile (<48.5 cm/sec vs. ≥64.9 cm/sec; HR: 2.680, 95% CI: 1.136-6.318; P = 0.024). The risk of AF recurrence was also higher in the highest tertile of LAVI (≥34.2 mL/m2) compared with the lowest tertile, but this difference was not significant (HR: 2.146, 95% CI: 0.834-5.523; P = 0.113). Conclusions LAAFV (reflecting functional remodeling) and PA- TDI (reflecting electrical remodeling) are independent predictors of AF recurrence after RFCA for PAF. [ABSTRACT FROM AUTHOR]