Arrhythmias & electrophysiologyCohort study
Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation
- Retrospective analysis of a prospective registry
Authors' conclusion
Atrial fibrillation phenotype and LA volume are independent predictors of outcome after PVI. Persistent AF with no/mild LA dilation has a similar risk of recurrence as paroxysmal AF with a moderate/severe LA dilation
Study context
- Population
- Patients with atrial fibrillation (AF) undergoing a first pulmonary vein isolation (PVI)
- Participants
- 476 patients
- Exposure
- AF phenotype and left atrial (LA) volume index as predictors of outcome after PVI
- Outcome
- AF recurrence (single-procedure freedom from arrhythmia recurrence)
- Follow-up
- 1 year
Main finding
As reported in the abstract
Freedom from arrhythmia recurrence
Paroxysmal AF
65.6
%
Persistent AF
52.7%
LA volume index (LAVI) <42 mL/m²
67.1%
LAVI ≥42 mL/m²
53%
Paroxysmal AF vs Persistent AF: P = 0.003 · LAVI <42 mL/m² vs LAVI ≥42 mL/m²: P < 0.001
- Overall single-procedure freedom from arrhythmia recurrence
- 61.5%
- Combination of AF phenotype and LAVI refined prediction of 1-year recurrence
- P < 0.001
Observational data: associations, not effects.
Further findings
Comorbidities by AF phenotype
- Obesity, hypertension, CKD and HF significantly more frequent in persistent AF
Original publication
Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation. Europace. Published 10 April 2024. doi:10.1093/europace/euae071
Summarised from the published abstract; every number is checked against it