Left atrial volume index a potential predictor of AF recurrence

Left atrial volume index (LAVI) can be used as a reliable and accurate predictor of atrial fibrillation (AF) recurrence after the pulmonary vain isolation through cryo-ablation, a new study has shown.

A total of 415 patients (median age, 60.0 years; 69.9 percent male) participated in the tudy. All participants underwent cardiac computed tomography (cCT) imaging, followed by index cryo-ablation. The endpoint was the recurrence of AF, defined as a composite of electrocardiogram detection, electrocardioversion due to recurrence, and/or the need to redo the index procedure.

More than half (n=224; 54.98 percent) of the participants had positive outcomes and did not develop AF recurrence; the remaining 46.02 percent (n=191), however, met the composite definition of recurrence.

Both groups differed significantly in terms of LAV and LAVI. Median LAV in patients who did not see AF recurrence was 97.00 mL, as opposed to 114.00 mL in those who did; the respective median LAVI values were 49.96 and 56.07 mL/m² (p<0.001 for both measures).

After grouping participants according to terciles of LAVI, the researchers applied a Kaplan-Meier curve to analyse the cumulative freedom from AF recurrence across the categories and over time. They found a significant between-group difference (p<0.001), indicating that LAVI could potentially be a useful stratifying factor for assessing AF recurrence risk.

Multivariate Cox regression analysis confirmed the main findings and showed that both the second (adjusted hazard ratio [HR], 1.604, 95 percent confidence interval [CI], 1.051–2.450; p=0.029) and third (adjusted HR, 1.907, 95 percent CI, 1.284–2.833; p<0.001) terciles saw a higher risk of recurrence. As a stand-alone variable, LAVI had an adjusted HR of 1.022 (95 percent CI, 1.013–1.031).