Abstract 19134: Association Between CHA 2 DS 2 -VASc and LA Volume Index: Insights From DECAAF II

Abstract

Introduction: LA Volume is strongly associated with atrial fibrillation (AF) and underlying atrial myopathy. The CHA 2 DS 2 -VASc score predicts stroke risk in patients with AF. The aim of this study is to investigate the relationship between the two. Methods: In this subanalysis of the DECAAF II trial, patients with persistent AF undergoing first-time catheter ablation underwent a baseline late gadolinium enhancement magnetic resonance imaging (LGE-MRI) within one month prior to ablation. LA Volume Index (LAVI) was defined as LA Volume on the MRI prior to ablation divided by body surface area ( mL/m2 ). The CHA2 DS2 -VASc score was also calculated at baseline prior to ablation. Analysis of Variance (ANOVA) test and linear regression were used to study the association between the two. Results: 815 patients were included, (78.9% males, mean age 62.7 ± 9.1 years) (table). The mean LAVI was 62.2 ± 18.9 mL/m2, and mean CHA2 DS2 -VASc score was 1.7 ± 1.27. The ANOVA test showed significant differences between group (F = 7.71, p <0.001). For every point increase in CHA2 DS2 -VASc score, LAVI increases by 3 (LAVI = 2.99 * CHA2 DS2 -VASc + 57; p <0.001) (figure). Conclusions: Our data suggests that structural remodeling in patients with AF is likely driven by multiple factors. There was a clear association between CHA2 DS2 -VASc score and higher LAVI. Serial analysis of LA Volume at different time points is needed to further understand the impact of individual comorbidities on LA volume dilation.