A three-year longitudinal study of the relation between left atrial diameter remodeling and atrial fibrillation ablation outcome

作     者：Hui-Ling Lee Yi-Ting Hwang Po-Cheng Chang Ming-Shien Wen Chung-Chuan Chou 

作者机构：Department of Anesthesia Chang Gung Memorial Hospital Taipei Taiwan China Department of Statistics National Taipei University Taipei Taiwan China Division of Cardiology Department of Internal Medicine Chang Gung Memorial Hospital Taipei Taiwan China Chang Gung University College of Medicine Taoyuan Taiwan China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2018年第15卷第7期

页      面：496-501页

核心收录：

学科分类：0832[工学-食品科学与工程（可授工学、农学学位）] 02[经济学] 0202[经济学-应用经济学] 020208[经济学-统计学] 07[理学] 08[工学] 0714[理学-统计学（可授理学、经济学学位）] 083202[工学-粮食、油脂及植物蛋白工程] 070103[理学-概率论与数理统计] 0701[理学-数学] 

主　　题：Atrial fibrillation Left atrial diameter Longitudinal data Radiofrequency catheter ablation Two-stage model 

摘      要：Background The long-term prognostic influence of left atrial diameter （LAD） remodeling on the status of post-radiofrequency catheter ablation （RI CA） atrial fibrillation （AF） is unclear. This study employed a two-stage model from 3-year echocardiographic data to ascertain whether the two-stage model predicts RFCA outcome more favorably than models using the baseline LAD. Methods Data were retrospectively collected from 263 consecutive patients with drug-refractory AF undergoing RFCA. Regular echocardiographic measurements of LAD were performed at baseline, 1, 3, 6, and 12 months and then every 6 months after RFCA. Sex, age, type of AF, number of RFCA, and AF status were recorded. We obtain the actual （predicted） 3-year LAD using a longitudinal linear mixed model （1st stage）. Logistic regression models based on the baseline LAD （Model 1）, actual （predicted） 3-year LAD （Model 2） （2nd stage）, and observed 3-year LAD （Model 3） were constructed to predict RFCA outcome. The area under the receiver operating characteristic curve （AUC） were used to assess the performance of models. Results The lowess smoothed curve indicated that the LAD declined over the first three months and remained stable up to 36 months after RFCA. The degree of LAD reduction was significantly influenced by the baseline LAD. Non-paroxysmal AF, large LAD and female gender were significant predictors of AF recurrence. Model 2 had the largest AUC among the three models. Conclusions This longitudinal study-based two-stage model outperforms the original logistic model using the baseline LAD. Non-paroxysmal AF, larger LAD and female gender are significant predictors of RFCA failure.