Left atrial shape is independent predictor of arrhythmia recurrence after catheter ablation for atrial fibrillation: A shape statistics study.
Atrial fibrillation
CT
Catheter ablation
Left atrial shape
Recurrence
Statistical shape modeling
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
entrez:
6
1
2022
pubmed:
7
1
2022
medline:
7
1
2022
Statut:
epublish
Résumé
Markers of left atrial (LA) shape may improve the prediction of postablation outcomes in atrial fibrillation (AF). Correlations to LA volume and AF persistence limit their incremental value over current clinical predictors. To develop a shape score independent from AF persistence and LA volume using shape-based statistics, and to test its ability to predict postablation outcome. Preablation computed tomography (CT) images from 141 patients with paroxysmal (57%) or persistent (43%) AF were segmented. Deformation of an average LA shape into each patient encoded patient-specific shape. Local analysis investigates regional differences between patient groups. Linear regression was used to remove shape variations related to LA volume and AF persistence, and to build a shape score to predict postablation outcome. Cross-validation was performed to evaluate its accuracy. Ablation failure rate was 23% over a median 12-month follow-up. Regions associated with ablation failure mostly consisted of a large area on posteroinferior LA, mitral isthmus, and left inferior vein. On univariate analysis, strongest predictors were AF persistence ( Posteroinferior LA, mitral isthmus, and left inferior vein are the regions whose shape have the highest impact on outcome. LA shape predicts AF ablation failure independently from, and more accurately than, atrial volume and AF persistence.
Sections du résumé
BACKGROUND
BACKGROUND
Markers of left atrial (LA) shape may improve the prediction of postablation outcomes in atrial fibrillation (AF). Correlations to LA volume and AF persistence limit their incremental value over current clinical predictors.
OBJECTIVE
OBJECTIVE
To develop a shape score independent from AF persistence and LA volume using shape-based statistics, and to test its ability to predict postablation outcome.
METHODS
METHODS
Preablation computed tomography (CT) images from 141 patients with paroxysmal (57%) or persistent (43%) AF were segmented. Deformation of an average LA shape into each patient encoded patient-specific shape. Local analysis investigates regional differences between patient groups. Linear regression was used to remove shape variations related to LA volume and AF persistence, and to build a shape score to predict postablation outcome. Cross-validation was performed to evaluate its accuracy.
RESULTS
RESULTS
Ablation failure rate was 23% over a median 12-month follow-up. Regions associated with ablation failure mostly consisted of a large area on posteroinferior LA, mitral isthmus, and left inferior vein. On univariate analysis, strongest predictors were AF persistence (
CONCLUSION
CONCLUSIONS
Posteroinferior LA, mitral isthmus, and left inferior vein are the regions whose shape have the highest impact on outcome. LA shape predicts AF ablation failure independently from, and more accurately than, atrial volume and AF persistence.
Identifiants
pubmed: 34988507
doi: 10.1016/j.hroo.2021.10.013
pii: S2666-5018(21)00210-5
pmc: PMC8703187
doi:
Types de publication
Journal Article
Langues
eng
Pagination
622-632Informations de copyright
© 2021 Heart Rhythm Society. Published by Elsevier Inc.
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