Abstract 16393: Left Atrial Calcification on Cardiac Computed Tomography and Rhythm Outcome in Patient Underwent Mitral Valve Surgery

IntroductionLeft atrial (LA) calcification (LAC) is often observed in patients who underwent mitral valve (MV) surgery, little is known about its association with sinus node dysfunction (SND) and incidence of permanent pacemaker (PM) implantation.HypothesisWe hypothesized that LAC on cardiac computed tomography (CT) would be associated with poor rhythm outcomes in patients who have repaired or prosthetic MV.MethodsA total of 327 patients with repaired or prosthetic MV who underwent cardiac CT from 2010 to 2017 were investigated. We classified the degree of LAC into 3 groups according to the extent of calcification within LA; no LAC (group 1, n=247), mild to moderate LAC (group 2, less than 50% of LA circumference, n=56), and severe LAC (group 3, more than 50% of LA circumference, n=24). SND was defined as electrocardiographic manifestations, such as junctional bradycardia, symptomatic sick sinus syndrome, or symptomatic sinus bradycardia. Clinical and echocardiographic characteristics, and rhythm outcome [SND or permanent PM implantation] were compared in 3 groups.ResultsGroup 2 and 3 showed more prevalent atrial fibrillation, rheumatic etiology, a higher number of previous surgeries, larger LA volume index and higher pulmonary artery systolic pressure than group 1. In terms of rhythm outcomes, group 2 and 3 revealed more prevalent SND (48.2% and 54.2 %) than group 1 (24.4%) (ANOVA p