Left atrial volume index predicts atrial fibrillation recurrence after radiofrequency ablation: A meta-analysis

doi:10.3969/j.issn.1004-583X.2022.11.001

Abstract

Abstract:

Objective To evaluate the clinical value of left atrial volume index (LAVI) in predicting recurrence in patients with atrial fibrillation (AF) after radiofrequency ablation (RFA). Methods PubMed, the Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), China Biomedical Literature Database, VIP database, etc. were performed a computer search to find relevant literature regarding LAVI predicting recurrence after RFA in AF patients. Meta-analysis was performed using STATA 12.0. Results A total of 13 studies involving 1519 patients were eligibly included in this meta-analysis. The results of meta-analysis showed that patients with AF recurrence had a higher mean LAVI compared to patients with no recurrence ( $S M D$ =2.51, 95% $C I$ : 1.61-3.41, $P$ =0.001). After RFA, there was a statistically significant difference in LAV/LAVI between non-recurrence patients and recurrence patients ( $O R$ =2.88, 95% $C I$ : 2.68-3.10, $P$ =0.001). This suggested that close monitoring of LAVI changes after RFA could effectively assess the possibility of postoperative recurrence. Conclusion Patients with AF recurrence following RFA have a higher mean LAVI compared to patients with no recurrence, which can be used as an effective index to evaluate AF recurrence after RFA. The conclusion still needs to be verified by more multi-center, large-sample randomized controlled trials.

Key words: atrial fibrillation, radiofrequency ablation, recurrence, left atrial volume index

CLC Number:

R541.75

Li Weiwei, Li Yanan. Left atrial volume index predicts atrial fibrillation recurrence after radiofrequency ablation: A meta-analysis[J]. Clinical Focus, 2022, 37(11): 965-968.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.11.001

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I11/965

Figures/Tables 6

References 22

[1]	胡翔稳, 张先林. 射频消融术治疗心房颤动术后复发相关因素的研究进展[J]. 实用心电学杂志, 2020, 150(2):62-65.
[2]	杨丹丹, 李学斌. 心房颤动合并心力衰竭的治疗进展[J]. 中国实用内科杂志, 2020, 40(3):187-190. doi: 10.19538/j.nk2020030103
[3]	陈璇, 王雨锋, 张筑欣, 等. 中国心律失常现状及治疗进展[J]. 中国研究型医院, 2020,(1): 3-5.
[4]	胡晓, 谷阳, 蒙涛, 等. 维生素D水平、左房容积指数与阵发性房颤患者射频消融术后复发的相关性研究[J]. 中国循证心血管医学杂志, 2019, 11(1):65-68.
[5]	Margulis AV, Pladeval lM, Riera-Guardia N, et al. Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: The Newcastle-Ottawa scale and the RTI item bank[J]. Clin Epidemiol, 2014, 5(3):22-34.
[6]	Shin SH, Park MY, Oh WJ, et al. Left atrial volume is a predictor of atrial fibrillation recurrence after catheter ablation[J]. J Am Soc Echocardiogr, 2008, 21(6):697-702. doi: 10.1016/j.echo.2007.10.022 URL
[7]	Kohári M, Zado E, Marchlinski FE, et al. Left atrial volume best predicts recurrence after catheter ablation in patients with persistent and longstanding persistent atrial fibrillation[J]. Pacing Clin Electrophysiol, 2014, 37(4):422-429. doi: 10.1111/pace.12279 URL
[8]	Helms AS, West JJ, Patel A, et al. Relation of left atrial volume from three-dimensional computed tomography to atrial fibrillation recurrence following ablation[J]. Am J Cardiol, 2009, 103(7):989-993. doi: 10.1016/j.amjcard.2008.12.021 pmid: 19327428
[9]	Kim MN, Lee JJ, Kim SA, et al. The difference of predictors for recurrence after catheter ablation of non-paroxysmal atrial fibrillation according to follow-up period[J]. Int Heart J, 2014, 55(4):312-318. doi: 10.1536/ihj.13-370 URL
[10]	Linhart M, Lewalter T, Mittmann-Braun EL, etal. Left atrial pressure as predictor for recurrence of atrial fibrillation after pulmonary vein isolation[J]. J Interv Card Electrophysiol, 2013, 38(2):107-114. doi: 10.1007/s10840-013-9803-9 pmid: 23793444
[11]	Yoshida K, Rabbani AB, Oral H, et al. Left atrial volume and dominant frequency of atrial fibrillation in patients undergoing catheter ablation of persistent atrial fibrillation[J]. J Interv Card Electrophysiol, 2011, 32(2): 155-161. doi: 10.1007/s10840-011-9590-0 pmid: 21671071
[12]	Nedios S, Kosiuk J, Koutalas E, et al. Comparison of left atrial dimensions in CT and echocardiography as predictors of long-term success after catheter ablation of atrial fibrillation[J]. J Interv Card Electrophysiol, 2015, 43(3):237-244 doi: 10.1007/s10840-015-0010-8 pmid: 25956477
[13]	Bary CV, Dornia C, Eissnert C, et al. Predictive value of left atrial volume measured by non-invasive cardiac imaging in the treatment of paroxysmal atrial fibrillation[J]. J Interv Card Electrophysiol, 2012, 34(2):181-188. doi: 10.1007/s10840-011-9641-6 pmid: 22228410
[14]	郑贻升. 胱抑素C及左房容积指数对心房颤动患者导管消融术后早期复发的预测价值[D]. 南宁: 广西医科大学, 2019.
[15]	彭红博. 左房容积指数(LVAI)与NT-proBNP对房颤射频消融术后早期复发的预测价值[D]. 大连: 大连医科大学, 2018.
[16]	曲红培, 宋溢娟, 汪砚雨, 等. 左房容积指数与射频消融术后房颤复发的关系[J]. 医药论坛杂志, 2015, 36(2):88-90.
[17]	DenUijl DW, Delgado V, Bertini M, et al. Impact of left atrial fibrosis and left atrial size on the outcome of catheter ablation for atrial fibrillation[J]. Heart, 2011, 97(22):1847-1851. doi: 10.1136/hrt.2010.215335 pmid: 21357370
[18]	周英, 张林潮. 心房颤动患者发生抗凝相关出血后重启抗凝治疗的研究进展[J]. 海南医学, 2019, 30(15):2017-2021.
[19]	史展, 孙雪荣, 田颖, 等. 心房颤动患者口服抗凝药物依从性的研究进展[J]. 心血管病学进展, 2020, 41(1):18-22.
[20]	Haïssaguerre M, JaïsP, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.[J]. N Engl J Med, 1998, 339(10):659-666. doi: 10.1056/NEJM199809033391003 URL
[21]	卫越, 吴立群. 导管消融治疗心房颤动伴心力衰竭的新进展[J]. 中国心脏起搏与心电生理杂志, 2019, 33(3):252-254.
[22]	王海军, 史扬, 李健, 等. 左房增大对起搏器术后的老年阵发性房颤患者再发房颤的影响[J]. 中国应用生理学杂志, 2017, 33(3):257-261.

纳入研究	地区	患者数量(例)	研究类型	随访时间(月)	检测方法	RFA方法	复发检测	NOS评分
胡晓等^[4], 2019	亚洲	54	回顾性	24	超声心动图	环肺静脉消融	Holter	8
Shin等^[6],2007	亚洲	68	前瞻性	6	超声心动图	环肺静脉消融	Holter	8
Kohári等^[7],2013	欧洲	125	回顾性	12	超声心动图	环肺静脉消融	心电图	8
Helms等^[8],2009	北美	73	前瞻性	12	CT	环肺静脉消融	Holter	8
Kim等^[9], 2014	亚洲	130	前瞻性	24	超声心动图	环肺静脉消融	Holter	9
Linhart等^[10], 2013	欧洲	205	前瞻性	12	超声心动图	环肺静脉消融	Holter	9
Yoshida等^[11],2011	北美	79	前瞻性	6	超声心动图	环肺静脉消融	心电图	9
Nedios等^[12], 2015	欧洲	103	回顾性	36	超声心动图	环肺静脉消融	Holter	9
Bary等^[13], 2012	欧洲	202	回顾性	6	MRI	环肺静脉消融	Holter	9
郑贻升等^[14], 2019	亚洲	54	回顾性	12	超声心动图	环肺静脉消融	Holter	8
彭红博等^[15], 2018	亚洲	138	回顾性	12	超声心动图	环肺静脉消融	Holter	9
曲红培等^[16], 2015	亚洲	118	回顾性	12	超声心动图	环肺静脉消融	心电图	8
Uijl等^[17], 2011	欧洲	170	前瞻性	12	超声心动图	环肺静脉消融	Holter	8

纳入研究	地区	患者数量(例)	研究类型	随访时间(月)	检测方法	RFA方法	复发检测	NOS评分
胡晓等^[4], 2019	亚洲	54	回顾性	24	超声心动图	环肺静脉消融	Holter	8
Shin等^[6],2007	亚洲	68	前瞻性	6	超声心动图	环肺静脉消融	Holter	8
Kohári等^[7],2013	欧洲	125	回顾性	12	超声心动图	环肺静脉消融	心电图	8
Helms等^[8],2009	北美	73	前瞻性	12	CT	环肺静脉消融	Holter	8
Kim等^[9], 2014	亚洲	130	前瞻性	24	超声心动图	环肺静脉消融	Holter	9
Linhart等^[10], 2013	欧洲	205	前瞻性	12	超声心动图	环肺静脉消融	Holter	9
Yoshida等^[11],2011	北美	79	前瞻性	6	超声心动图	环肺静脉消融	心电图	9
Nedios等^[12], 2015	欧洲	103	回顾性	36	超声心动图	环肺静脉消融	Holter	9
Bary等^[13], 2012	欧洲	202	回顾性	6	MRI	环肺静脉消融	Holter	9
郑贻升等^[14], 2019	亚洲	54	回顾性	12	超声心动图	环肺静脉消融	Holter	8
彭红博等^[15], 2018	亚洲	138	回顾性	12	超声心动图	环肺静脉消融	Holter	9
曲红培等^[16], 2015	亚洲	118	回顾性	12	超声心动图	环肺静脉消融	心电图	8
Uijl等^[17], 2011	欧洲	170	前瞻性	12	超声心动图	环肺静脉消融	Holter	8

纳入研究	平均年龄(岁)	男性(%)	合并高血压	合并糖尿病	合并冠心病	AF类型(%)
纳入研究	平均年龄(岁)	男性(%)	合并高血压	合并糖尿病	合并冠心病	阵发性	持续性	长期持续性
胡晓等^[4], 2019	51.2	21	NR	NR	NR	54	0	0
Shin等^[6],2007	55	95.72	45.58	8.99	13.77	58.8	41.3	0
Kohári等^[7],2013	61.3	79.66	68.23	14.97	13.76	0	77	23
Helms等^[8]2009	56	81.5	50.83	13.13	17.21	66	34	0
Kim等^[9], 2014	54.6	86.01	40.53	5.26	NR	0	100	0
Linhart等^[10], 2013	60	68.33	58	9.74	16.09	67	33	0
Yoshida等^[11],2011	62	83.16	50.35	22.2	20.57	0	100	0
Nedios等^[12], 2015	59	69.29	60.28	16.17	9.95	61.2	38.8	0
Bary等^[13], 2012	60	56.91	40.74	NR	21.24	100	0	0
郑贻升等^[14], 2019	53.56	71.9	16	NR	NR	32	22	0
彭红博等^[15], 2018	65.06	68	50	16	NR	107	31	0
曲红培等^[16], 2015	55.4	NR	26	19	NR	118	0	0
Uijl等^[17], 2011	55.9	77.00	45	NR	NR	71	29	0

纳入研究	平均年龄(岁)	男性(%)	合并高血压	合并糖尿病	合并冠心病	AF类型(%)
纳入研究	平均年龄(岁)	男性(%)	合并高血压	合并糖尿病	合并冠心病	阵发性	持续性	长期持续性
胡晓等^[4], 2019	51.2	21	NR	NR	NR	54	0	0
Shin等^[6],2007	55	95.72	45.58	8.99	13.77	58.8	41.3	0
Kohári等^[7],2013	61.3	79.66	68.23	14.97	13.76	0	77	23
Helms等^[8]2009	56	81.5	50.83	13.13	17.21	66	34	0
Kim等^[9], 2014	54.6	86.01	40.53	5.26	NR	0	100	0
Linhart等^[10], 2013	60	68.33	58	9.74	16.09	67	33	0
Yoshida等^[11],2011	62	83.16	50.35	22.2	20.57	0	100	0
Nedios等^[12], 2015	59	69.29	60.28	16.17	9.95	61.2	38.8	0
Bary等^[13], 2012	60	56.91	40.74	NR	21.24	100	0	0
郑贻升等^[14], 2019	53.56	71.9	16	NR	NR	32	22	0
彭红博等^[15], 2018	65.06	68	50	16	NR	107	31	0
曲红培等^[16], 2015	55.4	NR	26	19	NR	118	0	0
Uijl等^[17], 2011	55.9	77.00	45	NR	NR	71	29	0