Left atrial shape predicts recurrence after atrial fibrillation catheter ablation

Journal of Cardiovascular Electrophysiology
Erik T BiegingJoshua Cates

Abstract

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. 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 lateral...Continue Reading

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Citations

Jul 7, 2020·Circulation. Arrhythmia and Electrophysiology·Albert K FeenyPaul J Wang
Jan 14, 2021·Arrhythmia & Electrophysiology Review·Yan ZhaoNassir F Marrouche
May 7, 2021·The International Journal of Cardiovascular Imaging·Erik T BiegingJoshua Cates
Jul 23, 2021·Medical Image Analysis·Riddhish BhalodiaRoss Whitaker
Nov 9, 2021·European Heart Journal Cardiovascular Imaging·Caroline H RoneySteven A Niederer
Sep 11, 2021·Journal of Cardiovascular Medicine·Fuqian GuoYuanyuan Meng

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