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The impact of catheter ablation of atrial fibrillation on the left atrial volume and function: study using three-dimensional echocardiography

Authors
  • Hwang, Jongmin1
  • Park, Hyoung-Seob1
  • Han, Seongwook1
  • Jun, Seung-Woon1
  • Kang, Na-Young1
  • Jeon, Jin-Hwa1
  • Choi, Sang-Woong1
  • Lee, Cheol Hyun1
  • Kim, In-Cheol1
  • Cho, Yun-Kyeong1
  • Yoon, Hyuck-Jun1
  • Kim, Hyungseop1
  • Nam, Chang-Wook1
  • Hur, Seung-Ho1
  • 1 Keimyung University Dongsan Hospital,
Type
Published Article
Journal
Journal of Interventional Cardiac Electrophysiology
Publisher
Springer-Verlag
Publication Date
Dec 30, 2019
Volume
57
Issue
1
Pages
87–95
Identifiers
DOI: 10.1007/s10840-019-00696-8
PMID: 31889225
PMCID: PMC7036070
Source
PubMed Central
Keywords
License
Unknown

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/m2. 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. Electronic supplementary material The online version of this article (10.1007/s10840-019-00696-8) contains supplementary material, which is available to authorized users.

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