Background

Performing a cardiac CT scan before ablation provides a better understanding of the anatomical variations of the left atrium and pulmonary veins, as well as an analysis of coronary anatomy and the calcium score. The aim of the present study was to determine whether the CT characteristics of patients with unknown CAD have an impact on recurrence of AF.

Methods

This monocentric retrospective study included patients with AF who had undergone cardiac CT prior to a single ablation.

Results

Among the 229 patients included in the study, 70 (30.5%) presented AF recurrence between 3 and 12 months after a single ablation. The prevalence of CAD confirmed by CT coronary angiogram and the coronary calcium score were similar in the two groups. Patients with recurrent atrial fibrillation had a significantly higher LAVI evaluated by CT scan than patients without recurrence. The ROC curve determined an optimal LAVI threshold of 49 mL/m². In multivariate analysis, the LAVI measured by CT scan was independently associated with the risk of AF recurrence.

Conclusions

Our study confirms that CAD is not a predictor of AF recurrence after a single ablation, unlike the LAVI. Further studies are necessary to re-evaluate the long-term conclusions of this work.

中文翻译：

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心脏CT扫描发现的亚临床冠状动脉疾病对单次消融术后房颤复发无影响

背景

在消融前进行心脏 CT 扫描可以更好地了解左心房和肺静脉的解剖变异，以及对冠状动脉解剖和钙评分的分析。本研究的目的是确定未知 CAD 患者的 CT 特征是否对 AF 的复发有影响。

方法

这项单中心回顾性研究包括在单次消融前接受过心脏 CT 的 AF 患者。

结果

在纳入研究的 229 名患者中，70 名（30.5%）在单次消融后 3 至 12 个月内出现 AF 复发。两组CT冠状动脉造影证实的CAD患病率和冠状动脉钙化评分相似。CT 扫描评估的复发性房颤患者的 LAVI 显着高于未复发的患者。ROC 曲线确定了 49 mL/m ²的最佳 LAVI 阈值。在多变量分析中，CT 扫描测量的 LAVI 与 AF 复发的风险独立相关。

结论

我们的研究证实，与 LAVI 不同，CAD 不是单次消融后 AF 复发的预测因素。需要进一步的研究来重新评估这项工作的长期结论。