Key result
Catheter ablation yielded lower left atrial function recovery at 3 months than electrical cardioversion, with late transmitral peak velocity increasing only after ECV (42.1 to 56.7 cm/s; p<0.001).
Why the study?
Does catheter ablation differ from electrical cardioversion in affecting left atrial morphological and functional changes in patients with atrial fibrillation?
Cohort (n=63)
Does catheter ablation differ from electrical cardioversion in affecting left atrial morphological and functional changes in patients with atrial fibrillation?
Left atrial function recovers more slowly after catheter ablation compared to electrical cardioversion, suggesting a need for prolonged meticulous anticoagulation.
May support cautious anticoagulation prolongation after ablation; leaves open causal effects pending randomized confirmation.
BACKGROUND: The aim of this study was to assess whether the morphological and functional changes of the left atrium (LA) differ after catheter ablation (ABL) from those after electrical cardioversion (ECV) in atrial fibrillation (AF). METHODS AND RESULTS: AF patients who had maintained sinus rhythm for 3 months after either ECV (n=30) or ABL (n=33) were studied. Both 2-dimensional and Doppler echocardiography were performed at baseline, 1 week, 1 month, and 3 months after these procedures. LA dimensions, mitral inflow velocity, and tissue Doppler imaging of the mitral annulus were examined. LA dimensions decreased in both groups. The mean late mitral annulus velocity increased from 1 week to 3 months in both groups, but the mean late transmitral peak velocity increased only in the ECV group (42.1+/-14.4 cm/s to 56.7+/-14.8 cm/s, p<0.001 vs 38.7+/-12.5 cm/s to 44.8+/-16.7 cm/s, p=NS). CONCLUSION: Reverse morphological remodeling of the LA occurred after successful ABL and ECV for AF. However, because LA function was lower in the ABL group than in the ECV group and did not recover to the baseline levels until 3 months after ABL, a meticulous anticoagulation program should be considered.
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Choi et al. (2008) conducted a cohort in Atrial fibrillation (n=63). Catheter ablation vs. Electrical cardioversion was evaluated on Morphological and functional changes of the left atrium (LA dimensions, mitral inflow velocity, and tissue Doppler imaging). Catheter ablation yielded lower left atrial function recovery at 3 months than electrical cardioversion, with late transmitral peak velocity increasing only after ECV (42.1 to 56.7 cm/s; p<0.001).
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