Radiofrequency catheter ablation of atrial fibrillation significantly reduced the 3D left atrial volume index at 1 year compared to baseline (42.4 vs 47.2 ml/m2), indicating continuous structural remodeling.
Cohort (n=99)
Single-blind
No
Does radiofrequency catheter ablation improve left atrial volume and function in patients with paroxysmal or persistent atrial fibrillation?
Baseline 3D maximum left atrial volume index predicts atrial fibrillation recurrence after ablation, and structural remodeling of the left atrium continues up to 1 year post-ablation.
Absolute Event Rate: 42.4% vs 47.2%
p-value: p=<0.0001
Abstract Purpose The exact correlation between the baseline left atrial (LA) volume (LAV) and atrial fibrillation (AF) radiofrequency catheter ablation (RFCA) outcomes and changes to the LA after AF RFCA has not yet been fully understood. We sought to evaluate the serial changes in the LAV and LA function after RFCA using 3D echocardiography. Methods Consecutive patients who received RFCA of paroxysmal (PAF) or persistent AF (PeAF) at our center between January 2013 and March 2016 were included. Real-time 3D apical full-volume images were acquired, and a 3D volumetric assessment was performed using an automated three-beat averaging method. The LAV index (LAVI) was calculated and the LA ejection fraction (LAEF) was calculated as LAVmax − LAVmin/LAVmax. Results Ninety-nine total patients were enrolled, and the mean age was 58.0 ± 8.2 years and 75 (74.7%) were male. There were 59 (59.6%) PAF patients and the remaining 40 (40.4%) had PeAF. AF recurred in 5 of 59 (8.5%) PAF and in 10 of 40 (25%) PeAF patients. The LAVImax increased on 1 day, decreased at 3 months, and then increased again at 1 year but was lower than that at baseline. The LAEF changes were similar to the volume changes but were more prominent in PeAF than PAF patients. The baseline 3D LAVImax was an independent predictor of AF recurrence after RFCA and the cut-off value was 44.13 ml/m 2 . Conclusion In our study, even after 3 months of scar formation due to ablation, structural remodeling of the LA continued. The changes were more prominent in the non-recurrent, PeAF patients.
Hwang et al. (Mon,) conducted a cohort in Drug-refractory paroxysmal or persistent atrial fibrillation (n=99). Radiofrequency catheter ablation (RFCA) vs. Baseline was evaluated on 3D left atrial volume index (LAVImax) at 1 year compared to baseline (p=<0.0001). Radiofrequency catheter ablation of atrial fibrillation significantly reduced the 3D left atrial volume index at 1 year compared to baseline (42.4 vs 47.2 ml/m2), indicating continuous structural remodeling.