Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis

• Published in: Europace (London, England) Vol. 20; no. 1; pp. 33 - 42
• Main Authors: Njoku, Augustine, Kannabhiran, Munish, Arora, Rishi, Reddy, Pratap, Gopinathannair, Rakesh, Lakkireddy, Dhanunjaya, Dominic, Paari
• Format: Journal Article
• Language: English
• Published: England 01.01.2018
• Subjects: Radiofrequency ablation; Atrial fibrillation recurrence; Atrial fibrillation; Left atrial volume; Meta-analysis
• ISSN: 1099-5129; 1532-2092; 1532-2092
• DOI: 10.1093/europace/eux013

Left atrial (LA) diameter is a predictor of atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFA). However, LA volume (LAV) is more accurate in assessing LA size. Studies evaluating LAV as a predictor of AF recurrence are contradictory; therefore, we performed a meta-analysis to assess whether LAV is an independent predictor of AF recurrence following RFA. All studies reporting LAV/LAV index (LAVi) as a predictor of AF recurrence following RFA were included. For studies reporting mean LAV/ LAVi in patients with and without AF recurrence, standard difference in means (SDM) and standard errors were calculated, and combined using meta-analytical techniques. For studies reporting adjusted odds ratio (OR) for AF recurrence based on LAV/LAVi, log ORs were combined using generic inverse variance. Twenty one studies (3822 subjects) were included. Meta-analysis of 11 studies (1559 subjects) reporting LAV, showed that patients with AF recurrence had a higher mean LA volume compared to patients with no recurrence (SDM 0.801; CI 0.387-1.216). Data from 9 studies (1425 subjects) comparing LAVi showed that, patients with AF recurrence had a higher mean LAVi compared to patients with no recurrence (SDM-0.596; CI 0.305-0.888). Thirteen studies (2886 patients) reporting ORs for AF recurrence based on LAV/ LAVi, showed that LAV/LAVi was independently predictive of AF recurrence post-RFA (OR-1.032, CI- 1.012-1.052). Patients with AF recurrence following RFA have a higher mean LAV/LAVi compared to patients with no recurrence. Large LAV/LAVi increases the odds of AF recurrence post RFA.