Pre-Procedural Prediction of Termination of Persistent Atrial Fibrillation by Catheter Ablation as an Indicator of Reverse Remodeling of the Left Atrium

To assess proarrythmogenic effects after different techniques of radiofrequency catheter ablation, 427 patients with paroxysmal, persistent, and long-standing persistent atrial fibrillation (AF) were examined. The patients were randomized into four groups: antral pulmonary vein isolation (PVI) (Group I), PVI plus roof line and mitral isthmus ablation (Group II), anatomic ablation of ganglionated plexuses (GP) of the left atrium (Group III) and GP plus PVI (Group IV). At the end of follow up (34,43,2 months) the largest number of proarrythmogenic effects was observed in Group II, 24,8% (26 patients). In the remaining groups the percentage of proarrythmogenic effects did not exceed 11%, neither was there any significant difference among Groups I, III and IV. Thus, the creation of additional linear lesions in the left atrium is a predictor of proarrythmogenic effects during follow up.

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Association between left atrial reverse remodeling and maintenance of sinus rhythm after catheter ablation of persistent atrial fibrillation

Heart and Vessels ◽

10.1007/s00380-019-01475-1 ◽

2019 ◽

Vol 35 (2) ◽

pp. 239-245 ◽

Cited By ~ 3

Author(s):

Yoshihiko Kagawa ◽

Eitaro Fujii ◽

Satoshi Fujita ◽

Masaaki Ito

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Sinus Rhythm ◽

Left Atrial ◽

Persistent Atrial Fibrillation ◽

Reverse Remodeling ◽

Atrial Reverse Remodeling

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Abstract 2161: Left Atrium Reverse Remodeling After Pulmonary Vein Isolation. Will It Be a Predictor for Non-recurrence of Atrial Fibrillation?

Circulation ◽

10.1161/circ.118.suppl_18.s_678-c ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

kiyotake Ishikawa ◽

Yukihiko Yoshida ◽

Sumio Morita ◽

Kenji Furusawa ◽

Noriyoshi Kanemura ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Left Atrium ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Reverse Remodeling ◽

Transverse Diameter ◽

Before And After ◽

History Of ◽

Af Recurrence

Background: Left atrium (LA) dilation plays an important role in development and persistence of atrial fibrillation (AF). Some cases show structural reverse remodeling of LA after catheter ablation of AF. The aim of this study was to assess the clinical significance of LA reverse remodeling. Method and Results: Echocardiographic data before and after ablation was obtained in 173 cases who underwent pulmonary vein isolation from January 2006 to April 2008 (74.0% men, 61.0±11 years old; paroxysmal AF 114, persistent AF 34, permanent AF 25). Mean atrial diameter before ablation was 39.0±6.1mm (paroxysmal 37.7±5.6mm, persistent 40.7±5.3mm, and permanent 43.0±6.8mm) and LA reverse remodeling was defined as 10% decrement of LA transverse diameter. Half of the cases were taking anti-arrhythmic drugs after ablation, and AF recurrence occurred in 16.8% (29/173) during mean follow up period of 8.5±6.3 months. Reverse remodeling of LA was seen in 34.1% (59/173) and AF recurrence rate in this group was 11.9% (7/59), whereas 19.3% (22/114) without reverse remodeling (P=0.29). However, limited in patients with LA diameter over 40mm (44.5%; 77/173), 3.2% (1/31) of AF recurrence was seen in those with reverse remodeling, while 21.7% (10/46) without reverse remodeling (P=0.04). LA reverse remodeling was observed significantly frequent in patients without history of hypertension(41.5% without hypertension vs 25.6% with hypertension, P=0.036). Conclusion: LA reverse remodeling after catheter ablation of AF in dilated LA patient is a simple and useful predictor for non-recurrence of AF. Hypertension could be a disturbance for LA reverse remodeling.

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