Extensive Ablation During Pulmonary Vein Antrum Isolation Has No Adverse Impact on Left Atrial Function: An Echocardiography and Cine Computed Tomography Analysis

Abstract

Extensive ablation during PVAI does not cause deterioration in LA function, and may cause long-term improvement, especially in patients with higher AF burden.

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

“…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.…”

Cardiac cycle–dependent left atrial dynamics: Implications for catheter ablation of atrial fibrillation

“…Additionally, improvement in left atrial function has been noted after cardiac resynchronization for the treatment of heart failure (25). Atrial function is restored when the heart is returned to sinus rhythm, but whether atrial function post-ablation improves or declines compared to controls is controversial (26)(27)(28). The impact of scar formation, which has been shown to include around 30% of the LA endocardium, on contractility and conduction patterns is not fully understood (29).…”

Ablation vs. drug use for atrial fibrillation

“…Reverse morphological remodelling of the left atria and improvement of left ventricular diastolic and systolic functions after restoration of sinus rhythm by ablation have been demonstrated in a study in patients with isolated AF 17 and other studies have reported similar findings. 23,[37][38][39][40] Although it is difficult to base assessment of long-term outcome on retrospective data, as techniques have changed since catheter ablation for AF was first introduced, available data are encouraging. In Bordeaux University Hospital, for example, the overall success rate of catheter ablation for AF remained quite stable at 62-63% between 1 year and 6 years of follow-up, 5% of patients moving from failure to success or vice versa (P. Jaïs, unpublished results).…”