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What echocardiographic parameter predict a recurrence of atrial fibrillation after radiofrequency catheter ablation?
고려대학교 안암병원 순환기 내과
김미나, , 조동혁, 김수아, 김용현, 최종일, 박성미, 박상원, 김영훈, 심완주
Background Radiofrequency catheter ablation (RFCA) is an increasingly utilized treatment for patients with atrial fibrillation. But recurrence after RFCA remained as a main clinical problem. There has been studies regarding echocardiographic predictors of AF recurrence. But it has not been throughly examined, especially with Trans-esophageal echocardiography (TEE) Method 292 patients (Male=84.2%, mean age=55±10.4 yr) with non-valvular AF (paroxysmal AF=55%) who underwent catheter ablation for AF were enrolled .Trans-thoracic echocardiography (TTE) and TEE was performed before procedure. Definition of AF recurrence is that AF in EKG or 24hr EKG monitoring after 3 months later. We correlated with AF recurrence and LA volume, LA emptying fraction (EF), LAA emptying velocity, LAA EF and the presence of dense SEC Result In study population, AF recurrence after RFCA occurred in 88 patients (30.1%). Mean duration of AF history was 62.3 ± 60.1 months. In univariated analysis, increased LAVI (≥ 40ml/m2), impaired LAEF (≤ 20%), decreased LAA emptying velocity (≤ 40 Cm/sec) and LAA EF (≤ 20%) were risk factors on AF recurrence after RFCA ( Odds ratio=2.0, 4.02, 2.16 and 3.1, p-value=0.016, 0.006, 0.003 and 0.001, 95% confidence interval 1.14-3.52, 1.50-10.7, 1.3-3.59 and 1.62-5.88). Multivariated analysis demonstrated that only decreased LA EF was a significant influencing factor on AF recurrence (Odds ratio=2.83, p= 0.046, 95% CI=1.02-7.87) Conclusion Echocardiographic parameters reflecting left atrial and left atrial appendage dysfunction were significantly associated to recurrence of AF 3 months after RFCA rather than left atrial volume in selected AF patients.


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