Left Atrial Volume Quantified by MSCT Predicts Emergency Hospitalizations for AF and Arrhythmia Recurrence after Catheter Ablation

Author(s):

László-Lehel Bordi¹,²,³, Diana Opincariu¹, Theodora Benedek¹,²,³, István Kovács¹,²,³, Zsolt Parajkó¹,², Emese Márton¹,², Renáta Gerculy¹,², Imre Benedek¹,²,³

Affiliation:

¹ Clinic of Cardiology, Emergency Clinical County Hospital, Târgu Mureș, Romania
² “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, Târgu Mureș, Romania
³ Center of Advanced Research in Multimodal Cardiac Imaging, Cardio Med, Târgu Mureș, Romania

DOI: 10.2478/jce-2023-0004

ABSTRACT
Introduction: This study aimed to investigate the correlation between multislice computed tomography (MSCT)-derived parameters characterizing atrial enlargement and the frequency of emergency hospitalizations after catheter ablation for atrial fibrillation (AF). Methods: The study included 52 patients with paroxysmal or persistent AF, who presented criteria for interventional rhythm control strategies and underwent MSCT evaluation prior to ablation. Results: The majority of emergency hospital admissions were due to heart failure caused by high-frequency arrhythmia (90.33%), or by cardioembolic complications, causing acute stroke (9.67%). The number of emergency referrals was significantly increased in cases of moderately enlarged left atrial volume (69.23%), and re-admission was necessary for over three quarters of the patients with highly enlarged left atrial volume (76.92%, p = 0.02). The average recurrence rate of AF following ablation therapy was 28.84% during the one-year follow-up, being 0% for volumes <71.33 mL, 32% for volumes between 71.33 mL and 109.5 mL, and 53.84% for volumes >109.5 mL (p = 0.01). Conclusion: A large volume of the left atrium, determined by MSCT, is associated with a higher risk of emergency rehospitalizations following catheter ablation of AF.