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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2019, Number 1

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An Med Asoc Med Hosp ABC 2019; 64 (1)

Spherical index of the left atrial measured by tomography as a risk factor of recurrence of atrial fibrillation after ablation by radiofrequency of pulmonary veins

Guerrero PC, Vallejo VEP, Ricaño CMM, Fajardo JIA, Soto LME, Nava TSR

Language: Spanish
References: 26
Page: 22-28
PDF size: 214.54 Kb.


ABSTRACT

Introduction: Atrial fibrillation is the most common arrhythmia with several treatment controversies. Objective: To evaluate the sphericity index of the left atrium and the correlation as a risk factor for atrial fibrillation recurrence after pulmonary vein isolation ablation. To determine the structural alterations of the left atrium that are associated with an increased risk of recurrence. Material and methods: Between March 2012 and May 2016 an observational and comparative study of cases and controls was carried out. Patients with a diagnosis of atrial fibrillation who underwent pulmonary vein isolation ablation and had a computer tomography scan of the pulmonary veins in the Medical Center ABC were included. Results: Out of a total of 15 patients, the success of the ablation was established in nine (60%). When compared to the control group, patients with atrial fibrillation presented a higher antero-posterior diameter (27.18 ±versus 36.08 ± 5.4, p = 0.0001) and a higher septum-lateral diameter (33.45 ± 4.1 versus 40.27 ± 7.78, p = 0.007). As morphological factors associated with recurrence, a higher left atrial volume was found (120.59 ± 49.95 versus 66.65 ± 11.9), left atrial volume index (57.65 ± 19.77 versus 34.09 ± 7.06), septum-lateral diameter (43.95 ± 7.6 versus 36.07 ± 5.85) and longitudinal diameter (66.63 ± 8.3 versus 58.81 ± 6.2), with a statistical difference of p = 0.02, p = 0.01, p = 0.04, p = 0.05, respectively. Conclusions: Atrial fibrillation induces structural remodeling of the atrium. The spherical changes of the left atrium had a prognostic meaning in patients with recurrence.


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