Radiofrequency catheter ablation in patients with atrial fibrillation significantly increased left atrial appendage volume from 19.4 cm3 to 23.7 cm3, despite decreasing overall left atrial volume.
Observational (n=123)
No
Does radiofrequency catheter ablation of atrial fibrillation alter left atrial and left atrial appendage volume and hemodynamics?
Radiofrequency catheter ablation for atrial fibrillation is associated with a decrease in left atrial volume but an unexpected increase in left atrial appendage volume, highlighting potential post-ablation hemodynamic changes.
Tasa de eventos absoluta: 23.7% vs 19.4%
valor p: p=<0.001
Abstract Atrial fibrillation (AF) is known to cause adverse remodeling of left atrium (LA). Radiofrequency catheter ablation (RFCA) of AF is associated with decrease in LA volume. However, the impact of RFCA on left atrial appendage (LAA) volume and hemodynamic function is not fully understood. We analyzed 123 patients who underwent cardiac magnetic resonance imaging (MRI) evaluation before and after RFCA in Korea University Anam Hospital. LA and LAA volume were measured before and after RFCA based on cardiac MRI. Baseline LA volume was 99.5 ± 38.4 cm 3 and decreased to 74.6 ± 28.5 cm 3 after RFCA (p < 0.001). LA diameter measured with transthoracic echocardiography was also decreased after RFCA (43.3 ± 6.2 mm at baseline and 39.9 ± 5.9 mm at follow up; p < 0.001). However, LAA volume was significantly increased after RFCA (19.4 ± 8.5 cm 3 at baseline and 23.7 ± 13.3 cm 3 at follow up; p < 0.001). Total ablation time and additional substrate modification was associated with change in LA volume. After RFCA, average LAA velocity measured by transesophageal echocardiography was increased to 51.0 cm/sec from 41.1 cm/sec (p < 0.001). In conclusion, LAA volume was increased after RFCA in contrast to LA volume. Our data raise a concern about worsening hemodynamics of LA and LAA following RFCA and long term clinical significance of enlarged LAA after RFCA needs further evaluation.
Kim et al. (Mon,) conducted a observational in Atrial Fibrillation (n=123). Radiofrequency catheter ablation (RFCA) vs. Pre-RFCA baseline was evaluated on Left atrial appendage (LAA) volume (cm3) (p=<0.001). Radiofrequency catheter ablation in patients with atrial fibrillation significantly increased left atrial appendage volume from 19.4 cm3 to 23.7 cm3, despite decreasing overall left atrial volume.
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