Key result
RF PVI drives reverse biatrial remodeling but LA reservoir strain remains ~9% lower vs baseline.
Why the study?
Successful pulmonary vein isolation promotes left atrial reverse remodeling, but its effect on right atrial remodeling remains unclear.
Does radiofrequency pulmonary vein isolation improve right atrial volumes and function in patients with atrial fibrillation?
Cohort (n=43)
Does radiofrequency pulmonary vein isolation improve right atrial volumes and function in patients with atrial fibrillation?
Absolute Event Rate: 17% vs 18.6%
p-value: p=0.04
Radiofrequency pulmonary vein isolation results in reverse biatrial remodeling with improved right atrial function, but persistently impaired left atrial function at 3 months.
Persistent LA strain impairment post-PVI warrants caution in early functional assessment; leaves open long-term remodeling implications.
BACKGROUND: Successful pulmonary vein isolation (PVI) promotes left atrial (LA) reverse remodeling, but its effect on right atrial (RA) remodeling remains unclear. OBJECTIVE: The purpose of this study was to assess the impact of radiofrequency (RF) PVI on RA volumes and function in patients with atrial fibrillation by using cardiac magnetic resonance imaging. METHODS: Forty-three patients with atrial fibrillation (32 (74.4%) males; mean age 61±7 years) undergoing first RF PVI, without atrial flutter ablation, underwent 3 cardiac magnetic resonance scans: pre-PVI, early (<72 hours) post-PVI, and 3 months post-PVI. Indexed atrial volumes (RA maximal/minimal volume index and LA maximal/minimal volume index) and function were derived from 2- and 4-chamber cine images, with longitudinal atrial strain analyzed using feature tracking. RESULTS: ; P<.001). LA function, demonstrated by reservoir and contractile strain, was significantly diminished early post-PVI, which persisted at 3 months compared with baseline (from 18.6%±4.0% to 17.0%±3.4%; P=.04 and from 8.5%±3.0% to 6.9%±2.4%; P<.01, respectively). CONCLUSION: This study demonstrates that RF PVI results in reverse biatrial remodeling, with significant reductions observed in RA and LA volumes. RA function showed a significant improvement post-PVI, while LA function demonstrated persistent impairment at 3 months, possibly because of LA ablation scarring.
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Pouderoijen et al. (2025) conducted a cohort in Atrial fibrillation (n=43). Radiofrequency pulmonary vein isolation (RF PVI) vs. Baseline (pre-PVI) was evaluated on Left atrial reservoir strain (p=0.04). Radiofrequency pulmonary vein isolation resulted in reverse biatrial remodeling, but left atrial reservoir strain remained significantly impaired at 3 months compared with baseline (17.0% vs 18.6%; P=0.04).
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