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

Hwang, Jongmin; Park, Hyoung‐Seob; Han, Seongwook; Jun, Soo Han; Kang, Nayoung; Jeon, Jin-Hwa; Choi, Sang-Woong; Lee, Cheol Hyun; Kim, In-Cheol; Yoon, Hyuck–Jun; Kim, Hyungseop; Nam, Chang‐Wook; Hur, Seung‐Ho

doi:10.1007/s10840-019-00696-8

Cited by 11 publications

(17 citation statements)

References 22 publications

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“…Based upon the fact that LA function was improved in both groups it might be concluded that most of the effects appeared to result from ablation, not LAAC. Previous studies demonstrated that persistent AF ablation was associated with a dramatic improvement in mechanical cardiac functions, and this evidence further supports our inference (16,17). Moreover, simple CA can achieve better improvement of LA function as compared to the combined therapy before 3 months, and the difference between the two groups in LA reservoir and conduit function as assessed by strain indices began very early, from 1 week to 3 months after surgery.…”

Section: Discussionsupporting

confidence: 89%

Effect of Left Atrial Appendage Closure in Combination With Catheter Ablation on Left Atrial Function for Persistent Atrial Fibrillation

Yang

Liu

Feng

et al. 2021

Front. Cardiovasc. Med.

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Background: A single procedure combining left atrial appendage closure (LAAC) plus catheter ablation (CA) has been proven to be safe and feasible for treating atrial fibrillation (AF). However, the influence of treatment modality on left atrial (LA) function is not thoroughly explained.Objective: We aimed to investigate the changes of LA function in persistent AF patients undergoing concomitant LAAC and CA.Methods: The study population comprised 65 patients who underwent combined AF ablation and Watchman LAAC (combined therapy group) in our center, and 65 participants of the AF simple ablation group who were matched based on sex, age, CHA2DS2-VASc score and HAS-BLED score using propensity score matching. During the 1-year follow-up period, two-dimensional echocardiography and speckle tracking echocardiography were performed to assess LA reservoir, conduit, and contractile function.Results: The combined therapy was associated with a significant improvement in the LA reservoir function with increased expansion index and strain indices, including strain and strain rate (SR) during ventricular systole. Conduit function with SR during early ventricular diastole was also improved, as was contractile function with active atrial emptying fraction and SR during atrial systole. Similarly, LA reservoir and contractile function indices all improved continuously during follow-up after catheter ablation alone. At 3 months follow-up LA reservoir and conduit function with strain indices had a tendency to improve only in the simple procedure group. At 1-year follow-up there was no significant difference in either LA volumes or strain indices between the two groups.Conclusion: Both the combined therapy group and the simple ablation group demonstrated significant improvement in LA function. Based upon the fact that LA function was improved in both groups it might be concluded that most of the effects appeared to result from ablation, not LAAC; furthermore the additional LAAC procedure did not affect the improvement of LA function after CA.

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Section: Discussionsupporting

confidence: 89%

Effect of Left Atrial Appendage Closure in Combination With Catheter Ablation on Left Atrial Function for Persistent Atrial Fibrillation

Yang

Liu

Feng

et al. 2021

Front. Cardiovasc. Med.

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“…Данное обстоятельство, вероятно, связано: 1) с применением разного программного обеспечения (Soft) УЗИ-сканнеров, обеспечивающего один из двух возможных подходов, регистрирующим стрейн ЛП, либо от начала комплекса QRS (первый пик позитивный -в фазу резервуара ЛП), либо от начала зубца P на ЭКГ (анализируется первый негативный пик, соответствующий систоле ЛП); 2) значениями S ЛП, получаемыми в сроки наблюдения (follow up) от 3 мес. до 1,5 лет после проведения РЧА [2,9].…”

Section: Relationships Andunclassified

“…После самой процедуры РЧА динамика показателей объёма и S ЛП, как выяснили корейские учёные, проходит неоднозначно в течение 12 мес. наблюдения [2]. В исследование были включены 99 пациентов: средний возраст составлял 58,0±8,2 года, 75 больных (74,7%) мужчины, пароксизмальная ФП -59 пациентов (60%) и персистирующая ФП -40 пациентов (40%).…”

Section: Relationships Andunclassified

“…Как известно, возникновение ФП зависит от размеров левого предсердия (ЛП). В ряде исследований [2,3] сообщается о прямо пропорциональной связи между риском возникновения/рецидива ФП со степенью увеличения ЛП. Однако в последнее время появились работы, в которых указывается, что у части больных с пароксизмальной или персистирующей ФП отсутствует ремоделирование ЛП.…”

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“…В целом после проведения РЧА значительно улучшается качество жизни больных [1,7]. Несмотря на это, случаи рецидивов ФП встречаются нередко [2,4,5,8,9]. В течение последнего десятилетия ведутся активные поиски надёжных маркеров эффективности РЧА с помощью различных диагностических методов, в т.ч.…”

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Prediction of sinus rhythm maintenance after radiofrequency ablation in patients with atrial fibrillation using speckle tracking echocardiography and dynamics of left atrial structural and functional parameters

Musin¹,

Багманова²,

Gareev³

et al. 2021

Russ J Cardiol

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Aim. To evaluate the dynamics of left atrial volume (LAV), strain (S) during the reservoir phase and strain rate (SR) in patients with paroxysmal and persistent atrial fibrillation (AF), scheduled for catheter radiofrequency ablation (RFA), as well as to compare the predictive value of S and SR as a marker of maintaining sinus rhythm.Material and methods. A total of 19 patients (men, 11; women, 8) aged 62±10,7 years with AF were included in the study, 13 (67%) of whom had persistent AF, while 6 patients (33%) had paroxysmal AF Two-dimensional and speckle tracking N. Sh. echocardiography (EPIQ 7, Philips) were performed in all patients before ablation and 12 months after RFA.Results. The patients were divided into 2 groups: group 1 — no recurrent AF after RFA (n=12; 63%); group 2 — recurrent AF after RFA (n=7; 37%). According to 2D echocardiography, the baseline values of LAV and LAV index (LAVI) did not significantly differ between groups 1 and 2: 56,0±12,6 ml and 52,0±23,2 ml (p=0,78); 28,0±7,8 ml/m2 and 25,1±13,6 ml/m2 (p=0,85), respectively. The initial S values of the LA in the four-chamber (4C-) and two-chamber (2C-) apical views in group 1patients were higher than in those from group 2: 4C-S, 34,3±9,9% and 16,9±4,4% (p=0,0008); 2C-S, 29,2±8,3% and 14,5±4,4% (p=0,0011), respectively. Baseline SR values were higher in group 1 patients compared with group 2 in 4C- and 2C-views: 4C-SR, 2,36±0,37 s-1 and 1,39±0,50 s-1 (p=0,0013); 2C-SR 2,09±0,39 s-1 and 1,4±0,53 s-1 (p=0,0053), respectively. The LAV in group 1 became significantly less after RFA than its initial levels: 56,0±12,6 ml and 47,0±12,1 ml (p=0,008). The LAVI also significantly decreased 12 months after RFA as follows: 28,0±7,8 ml/m2 and 22,6±8,3 ml/m2 (p=0,02). In group 2, there was no decrease in either LAV or LAVI after 12 months: LAV, 52,0±23,2 ml and 54,0±12,1 ml (p=1,0); LAVI, 25,1±13,6 ml/m2 and 30,9±7,6 ml/m2 (p=0,3). In group 1, there was no significant change in LA S 12 months after RFA: 4C-S, 34,3±9,9% and 30,3±9,6% (p=0,287); 2C-S, 29,2±8,3% and 28,9±9,1% (p=0,82). In group 2, LA S levels in 4C- and 2C-views did not significantly change depending on the performed RFA procedure: 4C-S, 16,9±4,4% and 17,4±6,2% (p=0,12); 2C-S, 14,5±4,4% and 16,5±6,8% (p=1,0). According to the ROC analysis, the optimal cut-off values for baseline 4C-SR (1,8 s-1 (AUC=0,958)), 2C-SR (1,75 s-1 (AUC=0,899)), 4C-S (20,7% (AUC=0,976)), and 2C-S (19,2% (AUC=0,964)) were reliable individual predictors of sinus rhythm maintenance.Conclusion. A stable sinus rhythm 12 months after the RFA was maintained in patients with higher baseline LA S and SR levels. The baseline LA S and SR values have a high predictive value for AF recurrence in patients after RFA. In patients with effective RFA, LAV and LAVI decreased without changing the S and SR. There was no effect of LA reverse remodeling and improvement in LA S values in patients with recurrent AF after RFA.

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GSM-Net: A global sequence modelling network for the segmentation of short axis CINE MRI images

Uslu

2023

Computerized Medical Imaging and Graphics

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

Cited by 11 publications

References 22 publications

Effect of Left Atrial Appendage Closure in Combination With Catheter Ablation on Left Atrial Function for Persistent Atrial Fibrillation

Effect of Left Atrial Appendage Closure in Combination With Catheter Ablation on Left Atrial Function for Persistent Atrial Fibrillation

Prediction of sinus rhythm maintenance after radiofrequency ablation in patients with atrial fibrillation using speckle tracking echocardiography and dynamics of left atrial structural and functional parameters

GSM-Net: A global sequence modelling network for the segmentation of short axis CINE MRI images

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