Decreased pre-ablation left atrial appendage emptying flow velocity (SMD -0.54) and increased left atrial appendage volume (SMD 0.53) are significantly associated with increased odds of atrial fibrillation recurrence after catheter ablation.
Meta-Analysis (n=8,945)
Do pre-ablation left atrial appendage function and structure parameters predict the recurrence of atrial fibrillation after catheter ablation?
Large pre-ablation LAA structure and decreased LAA function are significant predictors of atrial fibrillation recurrence following catheter ablation.
Standardized Mean Difference: -0.54 (95% CI -0.68–-0.4)
p-value: p=<0.00001
Background The results of studies evaluating the left atrial appendage (LAA) function and structure as predictors of atrial fibrillation (AF) recurrence after catheter ablation (CA) are contradictory. Therefore, we performed a meta-analysis to assess whether the LAA function and structure can predict the recurrence of AF after CA. Methods The PubMed, EMBASE, Web of Science, and Cochrane library databases were used to conduct a comprehensive literature search. Finally, 37 studies encompassing 11 LAA parameters were included in this meta-analysis. Results Compared with those in the non-recurrence group, the recurrence group had increased LAA volume (SMD 0.53, 95% CI 0.36, 0.71 p 0.00001), LAA volume index, LAA orifice area, and LAA orifice short/long axis and decreased LAA emptying flow velocity (SMD -0.54, 95% CI -0.68, -0.40, P 0.00001), LAA filling flow velocity, and LAA ejection fraction, while there was no significant difference in LAA morphology or LAA depth. Conclusion Large LAA structure of pre-ablation (LAA volume, orifice area, orifice long/short axis, and volume index) and decreased LAA function of pre-ablation (LAA emptying flow velocity, filling flow velocity, ejection fraction, and LASEC) increase the odds of AF recurrence after CA. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD42022324533.
Han et al. (Thu,) conducted a meta-analysis in Atrial fibrillation recurrence after catheter ablation (n=8,945). Left atrial appendage emptying flow velocity vs. Patients without atrial fibrillation recurrence was evaluated on Atrial fibrillation recurrence (SMD -0.54, 95% CI -0.68, -0.40, p=<0.00001). Decreased pre-ablation left atrial appendage emptying flow velocity (SMD -0.54) and increased left atrial appendage volume (SMD 0.53) are significantly associated with increased odds of atrial fibrillation recurrence after catheter ablation.