Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function

Lemola, Kristina; Desjardins, Benoı̂t; Sneider, Michael; Case, Ian; Chugh, Aman; Good, Eric; Han, Jihn; Tamirisa, Kamala; Tsemo, Ariane; Reich, Scott; Tschopp, David; Igic, Petar; Elmouchi, Darryl; Bogun, Frank; Pelosi, Frank; Kazerooni, Ella A.; Morady, Fred; Oral, Hakan

doi:10.1016/j.hrthm.2005.06.026

Cited by 132 publications

(93 citation statements)

References 16 publications

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“…19, 20 In a small population study, Rodrigues et al noted an early reduction in atrial function within the first 12 h after ablation, with a subsequent improvement at 6 months. 19 The close monitoring of atrial function in the present study showed an unstable trend of atrial function during the follow-up period.…”

Section: Discussionmentioning

confidence: 98%

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Antolini

Brustio

Morello

et al. 2015

Circ J

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2576ANTOLINI M et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp dent predictor of LA function improvement at follow-up, but previous studies have not identified a cut-off of LA function able to predict LA functional recovery. 8 The aim of this mono-center prospective study was therefore to clarify the effect of AF ablation on LA function according to baseline atrial performance. Methods Patient EnrollmentFrom March to December 2013, all consecutive patients who underwent catheter ablation for paroxysmal or persistent AF in the electrophysiology laboratory were considered for enrollment. Only those who presented in sinus rhythm at baseline adiofrequency catheter ablation (RFCA) is an effective treatment in rhythm-control therapy for atrial fibrillation (AF), with a reduction in AF recurrence ranging from 50 to 80%. 1-3 By promoting a reduction in arrhythmic burden, RFCA improves symptoms and quality of life. 4,5Despite both structural and functional changes after RFCA having been extensively studied, the effect of AF ablation on left atrial (LA) function has not yet been sufficiently determined and remains a pivotal topic also with regard to the consequences of decision on whether to discontinue anticoagulation after successful ablation. 6 In patients with impaired LA function, the risk of thrombus formation is potentially augmented, irrespective of the classical risk factors. 7Pre-ablation LA function has been identified as an indepen- Background: Data are lacking on the effect of radiofrequency catheter ablation (RFCA) on atrial function. The aim of this study was to determine a cut-off of pre-ablation left atrial (LA) function in order to predict atrial functional recovery after RFCA. R

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Section: Discussionmentioning

confidence: 98%

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Antolini

Brustio

Morello

et al. 2015

Circ J

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“…LA RF ablation results in SR maintenance for a majority of patients with PAF and chronic AF, [28][29][30] thereby potentially reducing the risk of thromboembolism. However, LA RF ABL itself reduces LA transport function by up to 30%, 31 which may predispose patients to thromboembolism even in the setting of SR. Therefore, patients over 65 years of age or who have a history of stroke are often maintained on warfarin, even when there is no evidence of recurrent AF.…”

Section: Discussionmentioning

confidence: 99%

Changes in Left Atrial Structure and Function After Catheter Ablation and Electrical Cardioversion for Atrial Fibrillation

Choi

Seong

Park

et al. 2008

Circ J

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trial fibrillation (AF) occurs in 0.4% of the general population, increasing to 5% in those over 65 years of age, and it is the most common arrhythmia, increasing cardiac morbidity and mortality. 1 AF is related to the structural and functional remodeling of the left atrium (LA) and ventricle (LV) because of persistent arrhythmia. 2,3 To restore sinus rhythm (SR), both electrical cardioversion (ECV) and radiofrequency (RF) catheter ablation (ABL) have proven to be effective treatment modalities for patients with AF. 4 Reverse morphological remodeling of the LA and improvement in LV diastolic and systolic functions after restoration of SR by either treatment modality have been demonstrated. 5 However, differences in the degree and the time course of functional reverse remodeling of the LA according to the each treatment modality have not been investigated. The objective of this study was to investigate the morphological and functional changes of the LA and LV in patients with sustained SR either after ABL or ECV. Circulation Journal Vol.72, December 2008 Methods Study PopulationSixty-three AF patients who had maintained SR for 3 months after either ECV (n=30, M:F 24:6, mean age 58.6± 9.3 years) or ABL (n=33, M:F 27:6, mean age 55.9±10.2 years) were included. Patients who underwent re-do ablation were excluded. Paroxysmal AF (PAF) was defined as the occurrence of 2 or more episodes of AF during the previous 12 months, typically lasting fewer than 7 days and terminating spontaneously. Persistent AF (PeAF) was defined as AF episodes lasting more than 7 days typically requiring cardioversion for restoration of SR. 6 The 29 of 30 patients had PeAF in the ECV group and 21 of 33 patients had PAF in the ABL group. All clinical information was obtained from medical records, and all patients completed a written informed consent form to participate in the study. ECVECV was performed if LA thrombi were not seen on transesophageal echocardiography. Direct current (DC) shock was delivered during sedation induced with intravenous midazolam (0.04 mg/kg) and pentothal sodium (1.5 mg/kg). One defibrillator pad with a 10-cm diameter was placed in the second intercostal space on the right side parasternally, the other was placed in a left-sided lateral position along the midaxillary line. The cardioversion procedure started with 70 J or 100 J of stored energy followed by 125 J and 150 J until the restoration of SR or failure to convert. Continuous electrocardiographic (ECG) monitoring was performed for several hours after the procedure to assess the maintenance of SR. Background The aim of this study was to assess whether the morphological and functional changes of the left atrium (LA) differ after catheter ablation (ABL) from those after electrical cardioversion (ECV) in atrial fibrillation (AF). Methods and Results AF patients who had maintained sinus rhythm for 3 months after either ECV (n=30) or ABL (n=33) were studied. Both 2-dimensional and Doppler echocardiography were performed at baseline, 1 week, 1 month, and 3 months aft...

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“…1104,1105 A meta-analysis showed a significant decrease in LA volume but did not find significant changes in active LA function, including studies with persistent as well as PAF ablation procedures. 1106 However, because AF eliminates essentially all contractility of the LA, there is general agreement that restoration of sinus rhythm in patients with persistent AF improves atrial function if sinus rhythm is maintained.…”

Section: Outcomes Of Af Ablation In Populations Not Well Represented mentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function

Cited by 132 publications

References 16 publications

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Changes in Left Atrial Structure and Function After Catheter Ablation and Electrical Cardioversion for Atrial Fibrillation

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

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Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function

Cited by 132 publications

References 16 publications

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation – Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation – Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Changes in Left Atrial Structure and Function After Catheter Ablation and Electrical Cardioversion for Atrial Fibrillation

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

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Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –

Left Atrial Function After Radiofrequency Catheter Ablation of Atrial Fibrillation　– Can Pre-Ablation Function Predict Contractile Improvement During Follow-up? –