Catheter ablation of persistent atrial fibrillation significantly improved left atrial active emptying fraction from 18% at 24 hours post-ablation to 25% at 6 months (P=0.0001).
Cohort (n=20)
Does catheter ablation of persistent atrial fibrillation improve atrial function and reduce peri-atrial edema at 6 months?
CMR demonstrates that atrial dysfunction and peri-atrial edema following catheter ablation for persistent AF are reversible at 6 months in patients maintaining sinus rhythm.
Absolute Event Rate: 25% vs 18%
p-value: p=0.0001
INTRODUCTION: There is a paucity of data on atrial injury following ablation of persistent atrial fibrillation (AF). This study aimed at assessing reversibility of atrial dysfunction after successful persistent AF ablation using cardiovascular magnetic resonance (CMR). METHODS AND RESULTS: CMR was performed during sinus rhythm (SR) in 20 consecutive patients with persistent AF at baseline (BL) within 24 hours after ablation and after 6-month follow-up (FU). Catheter ablation included atrial substrate modification using the stepwise approach following pulmonary vein isolation (PVI) in order to attempt termination of persistent AF. Active left (LA) and right atrial (RA) function were quantified by calculating the active emptying fraction (AEF) from transvalvular flow profiles using velocity encoded (VENC) CMR. LA appendage (LAA) function was quantified by measurements of peak a-wave velocities from flow profiles perpendicular to the LAA orifice. Peri-atrial edema was assessed using black-blood T2 -weighted CMR. A significant improvement was found in LA-AEF from 18 (12-26)% at BL to 25 (22-35)% at FU (P = 0.0001). Furthermore, RA-AEF significantly increased from 31 (19-35)% at BL to 40 (35-51)% at FU (P < 0.0001). A significant improvement was also found for LAA a-wave velocities from 45 (31-65) cm/s at BL to 62 (49-75) cm/s at FU (P < 0.01). The area of peri-atrial edema on T2 -weighted CMR decreased from 1393 (1098-1797) mm(2) at BL to 24 (1-92) mm(2) at FU (P < 0.0001). CONCLUSION: CMR demonstrates reversibility of LA, LAA, and RA dysfunction associated with resorption of peri-atrial edema in patients with SR after persistent AF ablation.
Muellerleile et al. (Wed,) conducted a cohort in Persistent atrial fibrillation (n=20). Catheter ablation vs. Baseline (within 24 hours post-ablation) was evaluated on Left atrial active emptying fraction (LA-AEF) (p=0.0001). Catheter ablation of persistent atrial fibrillation significantly improved left atrial active emptying fraction from 18% at 24 hours post-ablation to 25% at 6 months (P=0.0001).