Abstract
Performing a cardiac CT scan before ablation provides a better understanding of the anatomical variations of the left atrium and pulmonary veins, as well as an analysis of coronary anatomy and the calcium score. The aim of the present study was to determine whether the CT characteristics of patients with unknown CAD on recurrence of AF. This monocentric retrospective study included patients with AF who had undergone cardiac CT prior to a single ablation. Among the 229 patients included in the study, 70 (30.5%) presented AF recurrence between 3 and 12 months after a single ablation. The prevalence of CAD confirmed by CT coronary angiogram and the coronary calcium score were similar in the two groups. Patients with recurrent atrial fibrillation had a significantly higher left atrial (LA) volume evaluated by CT scan than patients without recurrence. The ROC curve determined an optimal indexed LA dilation threshold of 49 mL/m 2 . In multivariate analysis, a left atrium on CT scan was independently associated with the risk of AF recurrence. Our study confirms that CAD is not a predictor of AF recurrence after a single ablation, unlike left atrial volume. Further studies are necessary to re-evaluate the long-term conclusions of this work, and also to better understand the contribution of CT in the immediate post-ablation period.
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