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No impact of sub-clinical coronary artery disease identified by cardiac CT scan on the recurrence of atrial fibrillation after a single ablation procedure

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

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.

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Abbreviations

ADDs:

Antiarrhythmic drugs

AF:

Atrial fibrillation

ARB II:

Angiotensin II receptor antagonist

BMI:

Body mass index

CAD:

Coronary artery disease

CEI:

Converting enzyme inhibitor

CFAEs:

Ablation of complex-fractionated atrial electrograms

CT:

Computed tomography

Cx:

Circumflex artery

CV:

Cardiovascular

HBP:

High blood pressure

LA:

Left atrium

LAVI:

Left atrial volume index

LVEF:

Left ventricular ejection fraction

LV EDV:

Left ventricular end-diastolic volume

LV ESV:

Left ventricular end-systolic volume

LMCA:

Left main coronary artery

LAD:

Left anterior descending

NOC:

New oral anticoagulants

PAD:

Peripheral artery disease

PVI:

Pulmonary venous insulation

RCA:

Right coronary artery

RF:

Radio frequency ablation

TIA:

Transient ischemic attack

VKA:

Vitamin K antagonist

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Acknowledgements

We would like to thank Mrs. RANKIN Suzanne for her proofreading work.

Author information

Authors and Affiliations

  1. Department of Cardiology, University Hospital Center Dijon-Bourgogne, 14 rue Gaffarel, 21079, Dijon Cedex, France

    Saliman Sakhy, Romain Didier, Margaux Blain, Thibault Leclercq, Adrien Artus, Ranny Issa, Yves Cottin & Gabriel Laurent

  2. Department of Imagery, University Hospital Center Dijon-Bourgogne, Dijon, France

    Thibault Leclercq & Alexandre Cochet

  3. PEC2 Research Team, EA 7460, Department of Health Sciences, University of Bourgogne-Franche-Comté, Dijon, France

    Maud Maza & Marianne Zeller

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  1. Saliman Sakhy
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Contributions

Conceptualization: YC, GL, MZ

Data curation: SK, MB, TL, AA, RD, RI

Formal analysis: MM, MZ

Funding acquisition: TL, AC, SS

Investigation: SS, TL, AC, GL, YC

Methodology: MZ, YC

Project administration: MM, MZ, YC

Resources: YC, GL, AC

Software: MM

Supervision: YC, GL

Validation: MZ

Visualization: MM

Writing original draft preparation: SS, YC

Writing—review and editing: MZ, RD, AC, GL

Corresponding author

Correspondence to Yves Cottin.

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Conflict of interest

YC is a consultant or speaker for Bayer, BMS/Pfizer, Boehringer Ingelheim, Novartis, Sanofi, and Servier. All the other authors declare no competing interests.

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Sakhy, S., Didier, R., Blain, M. et al. No impact of sub-clinical coronary artery disease identified by cardiac CT scan on the recurrence of atrial fibrillation after a single ablation procedure. J Interv Card Electrophysiol 64, 393–400 (2022). https://doi.org/10.1007/s10840-021-01018-7

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  • DOI: https://doi.org/10.1007/s10840-021-01018-7

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