Study on the influence of left atrium and atrial fibrillation on recurrence of atrial fibrillation

Atrial fibrillation (AF) is epidemic. It is the most common arrhythmia and occurs in approximately 1%-2% of the general population, affecting 6% of those older than the age of 65 years. In addition to much-feared consequences of stroke, heart failure, and cognitive dysfunction, up to nearly 90% of the patients with AF are symptomatic. In the management of AF patients, the goals include stroke prevention and arrhythmia management (rate vs. rhythm control). Rhythm control is often selected when patients have significant symptom burden. Direct current cardioversion (DCCV) aims to restore sinus rhythm (SR) in persistent AF. AF is correlated with electrical and structural remodelling, including fibrosis and enlargement of the left and right atrium. The larger the left atrium, the higher the risk for recurrence of AF. Increased left atrial (LA) diameter (LAd), LA area, and LA volume have been confirmed to predict recurrence of AF after cardioversion. The predictive value of right atrial (RA) area and diameter, indexed to body surface area, for such prediction was assessed only in 1 study. Currently, the left atrial volume index is an important parameter in predicting the recurrence of atrial fibrillation. In the future, we may have a balance between the left and right atrium in the recurrence of atrial fibrillation. Key words: Atrial fibrillation; Left atrial diameter; Left atrial volume index; Right atrial diameter; Right atrial volume index