Left atrial diameter in estimating success rates of radio-frequency ablation treating atrial fibrillation.

Mohamed Elsayegh; Mohamad Ali El Ghannam; Ayman Mahmoud Ammar; Ahmed Samy Taha; Ahmed Bahig El Kerdany

doi:10.35810/ects.v1i1.23

Mohamed Elsayegh Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Mohamad Ali El Ghannam Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ayman Mahmoud Ammar Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ahmed Samy Taha Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ahmed Bahig El Kerdany Faculty of Medicine, Ain Shams University, Cairo, Egypt

DOI: https://doi.org/10.35810/ects.v1i1.23

Keywords: atrial, fibrillation, radio-frequency ablation, left atrial diameter, mitralvalve

Abstract

Background: Ablation devices are being utilized in surgical procedures treating atrial fibrillation. Few studies seek to define a cut-off value for left atrial diameter size beyond which risks of procedure outweigh chance of sinus recovery. This study aims to identify a cut-off value for pre-operative left atrial diameter to assess the efficacy of surgical radio-frequency ablation for treatment of chronic atrial fibrillation in patients undergoing mitral valve surgery. Methods: A prospective 6-month follow-up cohort study was done, in which 40 patients were recruited during the period from May 2016 till April 2018. All patients had rheumatic mitral valve disease and permanent atrial fibrillation. Receiver operator characteristic (ROC) curves were used to calculate the area under the curve and cut-off value for left atrial diameter. The efficacy of the overall survival time was estimated using the Kaplan‐Meier method. Results: Pre-operatively left atrial diameter of 59 mm was significantly associated with decrease in the possibility of reverting to sinus rhythm after surgery (OR 0.292, p-value = 0.001). The cut-off value for left atrial diameter was 59mm (sensitivity = 93.3%, specificity = 96.1%). Kaplan-Meier survival estimates were 175.07 days (156.3 - 193.9) for patients with left atrial diameter < 59mm and 62.64 days (26.6-98.7) for patients with left atrial diameter > 59mm. Conclusion: In patients undergoing mitral valve, higher degrees of success are associated with smaller left atrial diameter in terms of conservation of the sinus rhythm post operatively.