Key result
Hybrid AF ablation with LAAC is linked to an ~8% LVEF increase and reduced LA volumes.
Why the study?
Hybrid AF ablation is a therapeutic option in non-paroxysmal AF, but cardiac mechanics changes after hybrid ablation plus epicardial LAA closure required examination.
Does hybrid AF ablation combined with epicardial LAA closure improve left atrial and left ventricular mechanics in patients with persistent atrial fibrillation?
Observational (n=50)
No
Does hybrid AF ablation combined with epicardial LAA closure improve left atrial and left ventricular mechanics in patients with persistent atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Hybrid AF ablation combined with epicardial LAA closure significantly and persistently improves left atrial and left ventricular mechanical and hemodynamic functions in patients with persistent atrial fibrillation.
Background and aims Hybrid atrial fibrillation (AF) ablation is a therapeutic option in non-paroxysmal AF. Our study examines cardiac mechanics changes after hybrid AF ablation plus epicardial closure of left atrial appendage (LAA). Methods All consecutive patients undergoing hybrid AF ablation at UZ Brussel were evaluated. They received pulmonary vein isolation (PVI), posterior wall isolation (LAPWI), and epicardial LAA closure. Left atrium (LA) and Left ventricle (LV) mechanics were analyzed, with the following measures obtained at baseline, post-ablation, and follow-up: 1) volumes (EDV, ESV); 2) ejection fraction (EF); 3) strain (ENDO GCS, ENDO GLS); 4) forces (LVLF, LVsysLF, LVim, LVs). Results A total of 50 patients were included. At follow-up, LAEDV decreased from baseline [44.7 mL vs 53.8 mL, P = 0.025]. LA ENDO GCS and GLS increased post-ablation, with further GLS improvement at follow-up. LV ENDO GCS and LV ENDO GLS also rose post-ablation [-26.7% vs. −22.5%, P < 0.001] and [-20.57% vs. −16.6%, P < 0.001], respectively. LVEF increased post-ablation [54.6% vs 46.3%, P < 0.001]. There was an increase in all LV hemodynamic forces (HDFs) and in particular: LVLF and LVsysLF increased post-ablation [15.5% vs 10.4%, P < 0.001] and [21.5% vs 14.11%, P < 0.001], respectively. LVim also increased post-ablation [19.6% vs 12.8%, P < 0.001]. Finally, there was an increase in LVs post-ablation compared to baseline [10.6% vs 5.4%, P < 0.001]. Conclusion In patients undergoing hybrid AF ablation, there was a significant and persistent improvement in the mechanical and hemodynamic functions of both LA and LV.
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Paparella et al. (2025) conducted an observational in Persistent Atrial Fibrillation (n=50). Hybrid AF ablation and epicardial LAA closure vs. Baseline was evaluated on Recurrence of any atrial tachyarrhythmias (ATas) >30 s after a 90-day blanking period. Hybrid atrial fibrillation ablation combined with left atrial appendage closure significantly improved left ventricular ejection fraction from 46.3% to 54.6% and reduced left atrial volumes.
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