The following is a summary of “LEFT ATRIAL VOLUME AND AGE ARE THE STRONGEST PREDICTORS OF ATRIAL FIBRILLATION BURDEN AFTER PULMONARY VEIN ISOLATION FOR PERSISTENT ATRIAL FIBRILLATION- FINDINGS FROM DECAAF II RANDOMIZED CONTROLLED TRIAL,” published in the March 2023 issue of Cardiology by Mekhael, et al.

For a study, researchers sought to identify the factors that predict the burden of atrial fibrillation (AF) one year after catheter ablation (CA) in patients with Persistent AF (PeAF). The AF burden provided a more detailed picture than the simple binary classification of AF recurrence after pulmonary vein isolation (PVI). 

The study analyzed PeAF patients who underwent PVI-only ablation in the DECAAF II randomized controlled trial, excluding those with left atrial linear ablations. The patient’s demographic data and magnetic resonance imaging (MRI) scans were examined. In addition, they were asked to send daily single-lead home electrocardiogram (ECG) strips and to record any symptoms they experienced. The AF burden was calculated by dividing the total number of days in AF by the total number of days when ECG strips were sent. The data were analyzed using univariate and multivariate models.

The study included 376 PeAF patients, and the mean AF burden was 17±24%. The results of the univariate analysis showed that age (r=0.2, P=0.001), baseline fibrosis (r=0.134, P=0.019), and left atrial volume (r=0.2, P<0.001) were positively correlated with AF burden after the blanking period. A multivariate model was then used to account for the variability in AF burden, and it was found that only age and left atrial volume were significantly related to AF burden. The multivariate model explained 12% of the variability in AF burden adjusted R2= 0.12, P<0.001).

The study concluded that age and left atrial volume were the most significant predictors of AF burden one year after PVI-only ablation for PeAF.

Source: jacc.org/doi/10.1016/S0735-1097%2823%2900450-3