Right Atrial Volume Calculated by Multi-detector Computed Tomography: Useful Predictor of Atrial Fibrillation Recurrence after Pulmonary Vein Catheter Ablation

抄録

We investigated whether right atrial (RA) volume could be used to predict the recurrence of atrial fibrillation (AF) after pulmonary vein catheter ablation (CA). We evaluated 65 patients with paroxysmal AF (mean age, 60+10 years, 81.5% male) and normal volunteers (57 ± 14 years, 41.7% male). Sixty-four-slice multi-detector computed tomography was performed for left atrial (LA) and RA volume estimations before CA. The recurrence of AF was assessed for 6 months after the ablation. Both left and right atrial volumes were larger in the AF patients than the normal volunteers (LA: 99.7+33.2ml vs. 59.7+17.4ml; RA: 82.9+35.7ml vs. 43.9+12ml; P<0.0001 for both). A total of 16 patients (24.6%) showed recurrence of AF, involving both atrial volumes (LA: 125.8+36.9ml in patients AF recurrence vs. 91.1+27.1ml in 49 patients with no recurrence, P = 0.001; RA: 117.5+ 40.9ml vs. 71.6+25.5ml, P<0.0001). The sensitivity with large LA volumes (>100ml) for predicting the recurrence of AF was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 69.4% in 34 of 49 patients without recurrence. The sensitivity with large RA volumes (>87ml) was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 75.5% in 37 of 49 patients without recurrence. RA volume is a useful predictor of the recurrence of AF, similar to LA volume.