Biatrial anatomical reverse remodelling after radiofrequency catheter ablation for atrial fibrillation: evidence from real-time three-dimensional echocardiography

Müller, Hajo; Noble, Stéphane; Keller, Pierre-Frédéric; Sigaud, Philippe; Gentil, Pascale; Lerch, René; Shah, Dipen; Burri, Haran

doi:10.1093/europace/eun187

Cited by 69 publications

(59 citation statements)

References 22 publications

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“…Albeit controversial, reverse remodeling of the atria does in fact appear to occur after the restoration of sinus rhythm, and may result in a progressive lowering of AF burden. 16,17 This is consistent with our observation that FIRM-guided rotor ablation appears to be associated with a diminished ability to maintain AF, thereby resulting in a progressive reduction of AF burden over time. When antiarrhythmic drugs and conventional ablation strategies for patients with recurrent persistent AF, FIRMguided rotor ablation seems to be an advantageous alternative.…”

Section: Discussionsupporting

confidence: 89%

A Focal Impulse and Rotor Mapping (FIRM) Ablation Approach for Recurrent Persistent Atrial Fibrillation

Langbein¹,

Károlyi²,

Rämmler³

et al. 2016

JICRM

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ABSTRACT. Focal impulse and Rotor Modulation (FIRM) has been introduced recently as a new approach for ablation of atrial fibrillation (AF). We report a case of FIRM-guided rotor ablation, performed in combination with (re)-pulmonary vein isolation in a patient with recurrent persistent AF and two previous failed conventional ablation procedures. Four rotors could be detected and successfully ablated in this patient, one in the right atrium and three in the left atrium. Notably, the patient experienced a short-term recurrence of AF with spontaneous conversion back to sinus rhythm 11 weeks after the procedure. However, now the patient has been in stable sinus rhythm for 19 months. This case highlights the need to effectively address the specific AF mechanisms, especially in patients with recurrent persistent atrial fibrillation. FIRM-guided rotor ablation seems to be a beneficial option for these patients.

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Section: Discussionsupporting

confidence: 89%

A Focal Impulse and Rotor Mapping (FIRM) Ablation Approach for Recurrent Persistent Atrial Fibrillation

Langbein¹,

Károlyi²,

Rämmler³

et al. 2016

JICRM

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“…It is possible that these structural and functional changes after arrhythmia ablation and sinus rhythm restoration occur due to a component of tachymyocardiopathy, as occur in the left ventricle. It is well-established that a component of tachymyocardiopathy is reversible after an effective treatment [18][19][20], and we also observed this finding in our study, with a reduction of LVEDD and LVESD, and an increase in LVEF. The exact mechanisms that lead to the reversibility of myocardial dysfunction in patients with tachyarrhythmia are unknown.…”

Section: Follow-up Studysupporting

confidence: 90%

Echocardiographic Biatrial Remodelling and Diastolic Function Assessment in Long-Term Follow-Up after Typical Atrial Flutter Ablation

Cabanas‐Grandío¹

2014

J Cardiovasc Med Cardiol

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Background: A reverse left atrial (LA) remodelling after atrial fibrillation (AF) ablation has been reported and a relationship between diastolic function and AF is well known. However, there is little information about atrial remodelling and diastolic function after cavotricuspid isthmus (CTI) ablation. We aimed to evaluate long-term biatrial remodelling and diastolic function in patients undergoing CTI ablation. Methods:A transthoracic echocardiography was performed at baseline and at longterm follow-up (6.3 ± 0.5 years) in a total of 39 patients who underwent AFl ablation. Right atrial end diastolic areas (RAEDA) and end systolic areas (RAESA), right atrial contraction fraction (RACF), mitral A wave velocity, E/A rate and LA diameter were measured. They were compared using the Wilcoxon rank sum test.Results: Mean (SD) age was 64 (10) years, 82% male, 49% hypertension and 44% prior AF episodes. Basal RAEDA and RAESA were higher than at follow-up: median (IQR) of 24.6 cm² (19.8-28.2) vs. 20.0 cm² (16.0-25.0), p = 0.017 and 17.4 cm² (13.0-19.3) vs. 12.0 cm² (9.8-17.0), p = 0.001, respectively. RACF was higher at follow-up: 0.41 (0.35-0.45) vs. 0.31 (0.19-0.37), p = 0.001. Basal mitral A wave velocity was lower than at follow-up: 0.51 (0.4-0.6) vs. 0.78 (0.7-0.9), p =0.001 and E/A rate was higher 1.9 (1.2-3.1) vs. 0.9 (0.7-1.1), p = 0.001. LA diameter at baseline was 44.8 mm (39.3-50.7) vs. 46 mm (41.5-51.5) at follow-up, p <0.001. Conclusion:AFl ablation led to reverse remodelling of the right atrium and improved diastolic dysfunction parameters in the long-term follow-up.limited studies suggest that AFl ablation also favours LA function recovery, as occurs after AF ablation [7]. However, there is no information about right atrial (RA) and LA anatomical remodelling in the long term follow-up after AFl ablation. Our objective was to investigate echocardiographic biatrial remodelling and diastolic function in the long-term follow-up after cavotricuspid isthmus (CTI) ablation. Methods Study populationWe included 39 patients who had undergone typical AFl ablation between January 2003 and May 2005 in which a complete echocardiographic study was performed at baseline (first 6 hours after ablation procedure) and at follow-up (mean ± SD of 6.3 ± 0.5 years) to assess echocardiographic remodelling.All patients included were over 18 years, with at least one episode of documented AFl in the previous 6 months, and demonstrated a CTI-dependent AFl during electrophysiological study, or CTI permeability with an electrocardiogram suggestive of typical AFl, in cases where the procedure was performed in sinus rhythm. IntroductionAtrial fibrillation (AF) is the most common arrhythmia seen in clinical practice and it is well-known that there is a relationship between AF and diastolic function [1]. It is also known that LA function is recovered after cardioversion to sinus rhythm as well as after AF ablation, and a reverse LA remodelling after AF ablation has also been reported [2][3][4][5]. ISSN: 2455-2976Citation: Cabanas...

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“…Результаты после операции «Лабиринт» характеризуются восста-новлением синусового ритма, физиологическим проведением импульса по предсердиям, нали-чием предсердного вклада и ремоделированием предсердий (рис. 3) [13,[25][26][27].…”

Section: Discussionunclassified

“…Радиочастотная ка-тетерная аблация фибрилляции предсердий пре-имущественно направлена на изоляцию легоч-ных вен и в настоящее время является наиболее часто применяемой терапией у большинства па-циентов с ФП [9]. Удержание синусового ритма приводит к уменьшению размеров правого и ле-вого предсердий (ЛП), которые в разных иссле-дованиях оценивались с помощью двухмерной и трехмерной эхокардиографии [10][11][12][13][14][15], а также магнитно-резонансной томографии [6,[16][17][18].…”

Section: Introductionunclassified

Evaluation of atrial remodeling in patients after maze procedure

Bockeriа¹,

Turdubaev²,

Макаренко³

et al. 2017

Ann aritmol

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Biatrial anatomical reverse remodelling after radiofrequency catheter ablation for atrial fibrillation: evidence from real-time three-dimensional echocardiography

Abstract: Three-dimensional echocardiography shows evidence of biatrial anatomical reverse remodelling after RFCA for AF. A reduction in the atrial volume occurs despite recurrence of AF.

Cited by 69 publications

References 22 publications

A Focal Impulse and Rotor Mapping (FIRM) Ablation Approach for Recurrent Persistent Atrial Fibrillation

A Focal Impulse and Rotor Mapping (FIRM) Ablation Approach for Recurrent Persistent Atrial Fibrillation

Echocardiographic Biatrial Remodelling and Diastolic Function Assessment in Long-Term Follow-Up after Typical Atrial Flutter Ablation

Evaluation of atrial remodeling in patients after maze procedure

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