Left Atrial Sphericity Predicts AF Ablation Outcome-Topic Video

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Video Summary

The speaker presented <strong>left atrial sphericity</strong>, a new 3D MRI-based measure of atrial shape remodeling in atrial fibrillation (AF). Because ablation outcomes remain only moderately successful, the goal was to identify better predictors of who will respond. In 106 AF patients undergoing pulmonary vein isolation, sphericity was measured by comparing the atrium’s shape to a best-fit sphere. It showed good reproducibility and outperformed left atrial size and volume in predicting 12-month AF recurrence. Patients with more spherical atria were more likely to have persistent AF, hypertension, and structural heart disease, and had significantly worse ablation outcomes. On multivariable analysis, only hypertension and left atrial sphericity remained independent predictors of recurrence; each 1% increase in sphericity raised recurrence risk. The speaker also suggested sphericity may reflect reverse remodeling after ablation and may improve stroke prediction when added to clinical scores.

Keywords

left atrial sphericity

atrial fibrillation

MRI-based measure

pulmonary vein isolation

ablation outcomes

AF recurrence prediction