Int J Med Sci 2020; 17(18):3031-3038. doi:10.7150/ijms.47568 This issue

Research Paper

Biatrial enlargement as a predictor for reablation of atrial fibrillation

Qiang Kong1, Lisheng Shi1, Ronghui Yu2, Deyong Long2, Yucong Zhang1, Yujia Chen1, Jing Li1✉

1. Division of cardiology, Capital Medical University Xuanwu Hospital, No. 45 Changchun Street, Xicheng District, Beijing 100053, PR China
2. Division of cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, PR China.

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Kong Q, Shi L, Yu R, Long D, Zhang Y, Chen Y, Li J. Biatrial enlargement as a predictor for reablation of atrial fibrillation. Int J Med Sci 2020; 17(18):3031-3038. doi:10.7150/ijms.47568. Available from

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Purpose: We aimed to determine whether biatrial enlargement could predict reablation of atrial fibrillation after first ablation.

Methods: 519 consecutive patients with drug resistant atrial fibrillation [paroxysmal AF (PAF) 361, non-PAF 158] who underwent catheter ablation in Capital Medical University Xuanwu hospital between 2009 and 2014 were enrolled. Biatrial enlargement (BAE) was diagnosed according to trans-thoracic echocardiography (TTE). Ablation strategies included complete pulmonary vein isolation (PVI) in all patients and additional linear ablation across mitral isthmus, left atrium roof, left atrium bottom and tricuspid isthmus, or electrical cardioversion on the cases that AF could not be terminated by PVI. Anti-arrhythmic drugs or cardioversion were used to control the recurred atrial arrhythmia in patients with recurrence of atrial fibrillation after ablation. Reablation was advised when the drugs were resistant or that patient could not tolerate. Risk factors for reablation were analyzed.

Results: After 33.11±21.45months, 170 patients recurred atrial arrhythmia, and reablation were applied in 117 patients. Multivariate Cox regression analysis demonstrated that that biatrial enlargement (BAE, HR 1.755, 95%CI 1.153-2.670, P=0.009) was an independent predictor for reablation and was associated with reablation (Log rank P=0.007).

Conclusion: Biatrial enlargement is an independent risk predictor for the reablation in atrial fibrillation patients after first ablation.

Keywords: Atrial fibrillation, Catheter ablation, Biatrial enlargement