| Summary: | 碩士 === 國立臺北大學 === 統計學系 === 105 === Atrial dilatation has a close causal-relationship with atrial fibrillation (AF). If AF becomes a normal sinus rhythm, the AF-related structural remodeling would be, at least in part, reversed. Echocardiography is widely used clinically to assess cardiac chamber sizes and function in AF patients. The left atrial diameter (LAD) is the most common used parameter to represent the left atrial size. The size or change of LAD is recognized as an important prognostic factor whether the AF radiofrequency catheter ablation (RFCA) is succeeded. Nevertheless, the long-term prognostic influence of LAD on status of AF after RFCA is lacking. This study is aimed to use the 3-year echocardiographic data to predict the status of AF after 3 years of the RFCA surgery.
A total of 263 patients who received RFCA for more than three years from July 2004 to March 2014 were included in the study. LAD was measured at 9 different time points including baseline, 1, 3, 6, 12, 18, 24, 30, 36 months post-surgery. Gender, age, type of AF, the number of operations, other diseases and the status of AF 3 years after RFCA surgery were also recorded. The two-sample T test and two-stage model were used to model the status of AF 3 years after RFCA surgery. The ROC curve and the area under the ROC curve (AUC) were used to assess the performance of various models.
The difference in LA size between the baseline and 3 years after RFCA was not significantly associated with the status of AF (P=0.3816). The linear mixed model found that the LAD was declined 3 months after RFCA and remained stable after 3 months. The predicted value obtained from the linear mixed model was used to predict the status of AF. The logistic regression model showed that the odds of having successful surgery declined when LAD increased. Finally, the two-stage model outperformed the logistic model that included only the observed LAD 3 years after RFCA. The result of this study can help the clinician to determine whether the RFCA surgery would work for the AF patients in the long run.
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