Pranav Bhagirath

100 Chapter 5 Table 2. Comparison of geometric remodeling after index procedure to AF recurrence after repeat ablation. No recurrence Recurrence* P value N 11 (44%) 14 (56%) Age (years) 60 ± 1 61 ± 7 0.76 Male (%) 82% 79% 0.84 Paroxysmal AF (%) 45% 36% 0.62 Duration of complaints (days) 2289 ± 1776 1853 ± 1337 0.51 LASP (%) Pre-procedural 83.6 ± 4.4 83.3 ± 2.7 0.84 Post-procedural 81.7 ± 4.8 84.7 ± 2.4 0.05 Change -1.9 ± 1.7 +1.4 ± 1.7 < 0.001 LASP, left atrial sphericity; * third episode of AF. Table 3. Correlation between LA remodeling parameters and number of isolated PV’s. Remodeling parameter Correlation with number of isolated PV’s (Pearson’s R) P value LA volume index (ml/m 2 ) Pre-procedural 0.05 0.81 Post-procedural 0.099 0.64 Change -0.114 0.59 LASP (%) Pre-procedural -0.528 0.007* Post-procedural -0.352 0.08 Change -0.196 0.347 LA, left atrium; LASP, left atrial sphericity. DISCUSSION This study investigated the relation of LA geometrical remodeling, expressed as sphericity, and maintenance of sinus rhythm after repeat pulmonary vein isolation. The results indicate that LA sphericity is a clinically useful parameter to predict the outcome of a repeat ablation procedure. The pattern of LA geometrical remodeling (positive versus negative) was found to be an independent predictor of procedural outcome in contrast to volumetric remodeling and conventional clinical parameters.