Small left atrial volume before ablation is a predictor of
tachycardia-induced cardiomyopathy with atrial fibrillation
Abstract
Abstract Introduction: Tachycardia-induced cardiomyopathy (TCM) is a
reversible cause of heart failure (HF) with impaired left ventricle (LV)
function. However, the diagnosis is difficult before treatment or
control of the arrhythmia for the first time. Methods: In this
retrospective observational study, we observed 32 patients with
paroxysmal or persistent atrial fibrillation (AF) who had impaired LV
function without structural heart disease and who underwent catheter
ablation. We defined impaired LV function as LV ejection fraction (LVEF)
<50%. After ablation, the LVEF became <60% (Group
1; n = 11) or 60% (Group 2; n = 21). We compared the differences in
baseline characteristics between the two groups. The patients in Group1
had no ischemic disease. A receiver operating curve (ROC) with area
under the curve (AUC) was used to evaluate the prediction efficiency.
Results: There were significant differences in left atrial (LA) volume
(LAV) and LAV adjusted by body surface area (LAVI) measured by computed
tomography (p < 0.05 for both). The AUCs were 0.810 and 0.823,
respectively. The points at which sensitivity and specificity were
maximum were 147 ml and 79. Small LAV and LAVI were predictors of LVEF
improvement. Conclusion: Small LAV measured by computed tomography (CT)
before ablation may be useful for diagnosis of TCM with AF.