Left And Right Atrial Difference Index As Predictors Of Paroxysmal Atrial Fibrillation Recurrence After Pulmonary Vein Isolation In Normal Right Atrial Size

Aims: While the left atrial size can predict the recurrence of atrial fibrillation after pulmonary vein isolation,it has limitations.This study sought to assess the value of left and right atrial difference index(LRADi)constructed based on right atrial size in predicting paroxysmal atrial fibrillation recurrence after pulmonary vein isolation in patients with normal right atrial size.Methods: 224 consecutive patients with paroxysmal atrial fibrillation and normal right atrial size who underwent first-time pulmonary vein isolation were included.We collected baseline characteristics and constructed LRADi from echocardiographic parameters.The related predictors were determined by univariate and multivariate Cox proportional hazard regression analysis,and Kaplan-Meier survival curve was plotted.Results: During the 12-month follow-up,49 patients experienced recurrence.In the multivariate Cox proportional hazard regression analysis,only LRADi is an independent predictor of atrial fibrillation recurrence after pulmonary vein isolation(≤-1.42,HR 0.45,95%CI: 0.21-0.96,P=0.039).LRADi demonstrated a predictive value with AUC of 0.602.The optimal cut-off value was-1.42 for LRADi.However,left atrial diameter did not predict recurrence.Conclusions: LRADi show promise as predictors of atrial fibrillation recurrence after pulmonary vein isolation,and may identify patients at an early stage in atrial remodelling.Further studies are required to confirm these findings.