Key result
Maintenance of sinus rhythm after catheter ablation significantly reduced atrial mitral regurgitation, decreasing effective regurgitant orifice area from 0.27 to 0.21 cm2 at 1 year.
Why the study?
To determine geometric changes in mitral annular and leaflet spatial conformation in AF complicated by severe atrial mitral regurgitation, exploring whether restoration of sinus rhythm improves this condition.
Does atrial fibrillation ablation improve severe atrial mitral regurgitation in patients with atrial fibrillation?
Observational (n=55)
No
Does atrial fibrillation ablation improve severe atrial mitral regurgitation in patients with atrial fibrillation?
Restoration of sinus rhythm via AF ablation significantly reduces severe atrial mitral regurgitation, driven by recovery of left atrial volume and mitral annular geometry.
Answers are grounded in this paper and cite their sources.
Supports sinus rhythm maintenance reducing atrial MR post-ablation; hypothesis-generating, needs RCTs before practice change.
The objective of the study was to determine the geometric changes in mitral annular and/or leaflets spatial conformation in patients with atrial fibrillation (AF) complicated with severe atrial mitral regurgitation (AMR) by using real-time 3-dimensional transesophageal echocardiography, aiming to explore whether this condition could be improved through self-modulation of mitral annulus and/or leaflets after the restoration of sinus rhythm.Fifty-five patients who were diagnosed with AMR and subject to 1-year follow-up were recruited in this clinical trial. All patients successfully received AF ablation. The intercommissural and anteroposterior diameter, annular height, mitral valve area (MVA), tenting height and volume, annular spherical index, fractional area change of MVA (MVA-FAC), and coaptation index (CP-I) were defined and measured by mitral-valve quantification software. Left ventricular size and function, maximum LA volume (LAV), and LA dimensions were equally recorded.During 1-year follow-up, AMR was significantly decreased in patients with sinus rhythm (P < 0.001). CP-I, MVA-FAC, and LAV index were independently associated with the reduction of AMR.AMR can be improved through the recovery of LAV after ablation, which probably affects the configuration of the annular space and the coaptation of the leaflets.
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Chen et al. (2019) conducted an observational in Atrial fibrillation complicated with severe atrial mitral regurgitation (n=55). Catheter ablation (maintenance of sinus rhythm) vs. AF recurrence was evaluated on Effective regurgitant orifice area (EROA) at 1 year (p=<0.001). Maintenance of sinus rhythm after catheter ablation significantly reduced atrial mitral regurgitation, decreasing effective regurgitant orifice area from 0.27 to 0.21 cm2 at 1 year.
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