Association of Atrial Fibrillation Recurrence with Right Coronary Atherosclerosis and Increased Left Arterial Epicardial Fat Following Catheter Ablation—Results of a Multimodality Study

Abstract

Background: Identification of predictors for atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) can lead to better long-term results. Our aim was to investigate the association between novel CT imaging markers reflecting the severity of coronary atherosclerosis and the risk of recurrence following PVI. Methods: This study included 80 patients with paroxysmal/persistent AF who underwent PVI. The patients were divided into two groups: Group 1–23 patients with recurrence and Group 2–57 patients without recurrence. Results: Patients with recurrence presented with a more enlarged left atrial diameter and reduced left ventricle EF, as assessed by echocardiography. Elevated calcium scores and right coronary artery (RCA) stenosis were correlated with a higher risk of AF recurrence (25.38 ± 4.1% vs. 9.76 ± 2.32%, p = 0.001). Patients with AF recurrence presented a higher left atrial volume index (LAVI) (61.38 ± 11.12 mm3/m2 vs. 46.34 ± 12.27 mm3/m2, p 3/m2 vs. 76.48 ± 17.61 mm3/m2, p p < 0.0001). Conclusions: RCA stenosis, together with atrial volumes and EAT-AS evaluated by CCTA, is associated with the risk of AF recurrence following PVI.

Keywords

• atrial fibrillation
• predictors for AF recurrence
• left atrium diameter
• calcium score
• left atrial volume index