Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation
Abstract Background Left atrial volume index (LAVI) of >34 mL/m2 is the cutoff value for identifying an enlarged left atrium. The definition of left atrial (LA) reverse remodeling after atrial fibrillation (AF) ablation is undetermined. We hypothesized that patients with LA dilatation who achieve...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-10-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12624 |
| _version_ | 1819107009485602816 |
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| author | Hiroshi Kawakami Katsuji Inoue Takayuki Nagai Akira Fujii Yasuhiro Sasaki Yukari Shikano Namiko Sakuoka Maki Miyazaki Yasunori Takasuka Shuntaro Ikeda Osamu Yamaguchi |
| author_facet | Hiroshi Kawakami Katsuji Inoue Takayuki Nagai Akira Fujii Yasuhiro Sasaki Yukari Shikano Namiko Sakuoka Maki Miyazaki Yasunori Takasuka Shuntaro Ikeda Osamu Yamaguchi |
| author_sort | Hiroshi Kawakami |
| collection | DOAJ |
| description | Abstract Background Left atrial volume index (LAVI) of >34 mL/m2 is the cutoff value for identifying an enlarged left atrium. The definition of left atrial (LA) reverse remodeling after atrial fibrillation (AF) ablation is undetermined. We hypothesized that patients with LA dilatation who achieve normal LA volume (LAVI<34 mL/m2) after AF ablation have better long‐term outcomes than those who do not. Furthermore, we investigated whether patients with a normal LA volume can also achieve normal LA function with AF ablation. Methods We enrolled 140 AF patients with baseline LAVI of ≥34 mL/m2, without AF recurrence for 1 year after the initial AF ablation. We acquired conventional and speckle‐tracking echocardiographic parameters within 24 hour and at 1 year after the procedure. To define the normal range of LA function, age‐ and sex‐matched controls without a history of AF were also enrolled. Results After restoration of sinus rhythm, LA structural and functional parameters significantly improved, and 75 patients (54%) had normal LA volume. During a median follow‐up of 44 (31‐61) months, 32 patients (23%) experienced a late recurrence of AF (AF recurrence >1 year). Patients who achieved normal LA volume after AF ablation had fewer late recurrences than those who did not (P < .01). However, LA abnormalities, especially LA dysfunction, persisted in AF patients even when the LA volume was normalized compared with controls. Conclusion Patients who achieved normal LA volume had better long‐term outcomes of AF ablation than those who did not; however, LA abnormalities persisted even after successful ablation of AF. |
| first_indexed | 2024-12-22T02:47:13Z |
| format | Article |
| id | doaj.art-e77def94ff9d4650875d598f73a898d2 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-22T02:47:13Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-e77def94ff9d4650875d598f73a898d22022-12-21T18:41:29ZengWileyJournal of Arrhythmia1880-42761883-21482021-10-013751318132910.1002/joa3.12624Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillationHiroshi Kawakami0Katsuji Inoue1Takayuki Nagai2Akira Fujii3Yasuhiro Sasaki4Yukari Shikano5Namiko Sakuoka6Maki Miyazaki7Yasunori Takasuka8Shuntaro Ikeda9Osamu Yamaguchi10Department of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Clinical Laboratory Ehime University Hospital Ehime JapanDepartment of Clinical Laboratory Ehime University Hospital Ehime JapanDepartment of Clinical Laboratory Ehime University Hospital Ehime JapanDepartment of Clinical Laboratory Ehime University Hospital Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanDepartment of Cardiology, Pulmonology, Hypertension & Nephrology Ehime University Graduate School of Medicine Ehime JapanAbstract Background Left atrial volume index (LAVI) of >34 mL/m2 is the cutoff value for identifying an enlarged left atrium. The definition of left atrial (LA) reverse remodeling after atrial fibrillation (AF) ablation is undetermined. We hypothesized that patients with LA dilatation who achieve normal LA volume (LAVI<34 mL/m2) after AF ablation have better long‐term outcomes than those who do not. Furthermore, we investigated whether patients with a normal LA volume can also achieve normal LA function with AF ablation. Methods We enrolled 140 AF patients with baseline LAVI of ≥34 mL/m2, without AF recurrence for 1 year after the initial AF ablation. We acquired conventional and speckle‐tracking echocardiographic parameters within 24 hour and at 1 year after the procedure. To define the normal range of LA function, age‐ and sex‐matched controls without a history of AF were also enrolled. Results After restoration of sinus rhythm, LA structural and functional parameters significantly improved, and 75 patients (54%) had normal LA volume. During a median follow‐up of 44 (31‐61) months, 32 patients (23%) experienced a late recurrence of AF (AF recurrence >1 year). Patients who achieved normal LA volume after AF ablation had fewer late recurrences than those who did not (P < .01). However, LA abnormalities, especially LA dysfunction, persisted in AF patients even when the LA volume was normalized compared with controls. Conclusion Patients who achieved normal LA volume had better long‐term outcomes of AF ablation than those who did not; however, LA abnormalities persisted even after successful ablation of AF.https://doi.org/10.1002/joa3.12624atrial fibrillationatrial remodelingcatheter ablationechocardiographyrecurrence |
| spellingShingle | Hiroshi Kawakami Katsuji Inoue Takayuki Nagai Akira Fujii Yasuhiro Sasaki Yukari Shikano Namiko Sakuoka Maki Miyazaki Yasunori Takasuka Shuntaro Ikeda Osamu Yamaguchi Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation Journal of Arrhythmia atrial fibrillation atrial remodeling catheter ablation echocardiography recurrence |
| title | Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| title_full | Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| title_fullStr | Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| title_full_unstemmed | Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| title_short | Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| title_sort | persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation |
| topic | atrial fibrillation atrial remodeling catheter ablation echocardiography recurrence |
| url | https://doi.org/10.1002/joa3.12624 |
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