Key result
In patients with non-paroxysmal AF undergoing RF ablation with LA appendectomy, restoration of sinus rhythm significantly improved left atrial ejection fraction (37.69% to 46.71%, P<0.05).
Why the study?
Stand-alone minimally invasive RF ablation with LA appendectomy is effective for non-paroxysmal AF and secondary stroke prevention, but its impact on LA function required assessment.
Does stand-alone minimally invasive radiofrequency ablation with left atrial appendectomy improve left atrial function in patients with non-paroxysmal atrial fibrillation?
Observational (n=37)
Does stand-alone minimally invasive radiofrequency ablation with left atrial appendectomy improve left atrial function in patients with non-paroxysmal atrial fibrillation?
Stand-alone minimally invasive RF ablation with LA appendectomy improves left atrial function in patients with non-paroxysmal AF who successfully restore sinus rhythm.
Should not yet change practice in non-paroxysmal AF; hypothesis-generating for LA function gains after successful rhythm restoration.
Background: Stand-alone minimally invasive radiofrequency (RF) ablation with left atrial (LA) appendectomy has been an effective surgical intervention for non-paroxysmal atrial fibrillation (AF) (NPAF) in patients with a medical history of thromboembolism for secondary stroke prevention. This study sought to assess the impact of this surgery on LA function. Methods: A total of 37 NPAF patients with a medical history of stroke or thromboembolism were enrolled in this prospective observational study, all of whom underwent stand-alone minimally RF ablation with LA appendectomy. Echocardiography was used to evaluate LA function preoperatively and 1 week and 3 months postoperatively. All patients were divided into two groups (Group AF and Group SR) according to whether sinus rhythm (SR) was restored after the surgery. Results: The surgery had no impact on LA function in Group AF. Once NPAF patients were restored to SR, LA minimal volume (LAVmin) decreased immediately compared with pre-operation (22.98±13.76 vs. 17.68±9.52 mL; P<0.05) and consequently LA reservoir function increased, including LAEF (37.69%±12.53% vs. 46.71%±8.53%, P<0.05) and LAEI (66.54%±34.39% vs. 92.15%±31.37%, P<0.05). PA-TDI of Group SR, indicating LA electromechanical coupling, were improved at three months of follow-up because of atrial stunning after the surgery (160.55±26.19 vs. 143.82±20.923 ms, P<0.05). LA contractile function was also improved at three months of follow-up (A-TVI: 2.95±1.16 vs. 5.10±1.85 cm, P<0.05). Conclusions: Stand-alone minimal invasive RF ablation with LA appendectomy had no impact on LA function in AF patients who could not be restored to SR. However, once AF patients were restored to SR after the surgery, LA function could recover better. Meanwhile, thromboembolic events could also be reduced after the surgery.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2020) conducted an observational in Non-paroxysmal atrial fibrillation (n=37). Restoration of sinus rhythm after minimally invasive RF ablation with LA appendectomy vs. Pre-operative baseline / No restoration of sinus rhythm was evaluated on Left atrial ejection fraction (LAEF) upon restoration to sinus rhythm (p=<0.05). In patients with non-paroxysmal AF undergoing RF ablation with LA appendectomy, restoration of sinus rhythm significantly improved left atrial ejection fraction (37.69% to 46.71%, P<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: