Short- and long-term associations of atrial fibrillation catheter ablation with left atrial structure and function: A cardiac magnetic resonance study.

Abstract

BACKGROUND:

The effects of atrial fibrillation (AF) catheter ablation on the left atrium (LA) are poorly understood.

OBJECTIVES:

To examine short- and long-term associations of AF catheter ablation with LA function using cardiac magnetic resonance (CMR).

METHODS:

Fifty-one AF patients (mean age 56 ± 8 years) underwent CMR at baseline, 1 day (n = 17) and 11 ± 2 months after ablation (n = 38). LA phasic volumes, emptying fractions (LAEF), and longitudinal strain were measured using feature-tracking CMR. LA fibrosis was quantified using late gadolinium enhancement (LGE).

RESULTS:

There were no acute changes in volume; however, active, total LAEF, and peak LA strain decreased significantly compared to the baseline. During long-term follow-up, there was a decrease in maximum but not minimum LA volume (from 99 ± 5.2 ml to 89 ± 4.7 ml; p = .009) and a decrease in total LAEF (from 43 ± 1.8% to 39 ± 2.0%; p = .001). In patients with AF recurrence, LA volumes were unchanged. However, total LAEF decreased from 38 ± 3% to 33 ± 3%; p = .015. Patients without AF recurrence had no changes in LA functional parameters during follow-up. The amount of LA LGE at long-term follow-up was higher compared to the baseline, however, was significantly less compared to immediately post-procedure (37 ± 1.9% vs. 47 ± 2.8%; p = .015). A higher increase in LA LGE extent compared to the baseline was associated with a greater decrease in total LAEF (r = -.59; p < .001).

CONCLUSIONS:

LA function is impaired acutely following AF catheter ablation. However, long-term changes of LA function are associated positively with the successful restoration of sinus rhythm and inversely with increased LA LGE.

• Authors: Mohammadali Habibi, Joao A C Lima, Esra Gucuk Ipek, David Spragg, Hiroshi Ashikaga, Joseph E Marine, Ronald D Berger, Hugh Calkins, Saman Nazarian
• Journal: Journal of cardiovascular electrophysiology (J Cardiovasc Electrophysiol) Vol. 32 Issue 2 Pg. 316-324 (02 2021) ISSN: 1540-8167 [Electronic] United States
• PMID: 33350536 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 Wiley Periodicals LLC.

Chemical References

• Contrast Media
• Gadolinium

Topics

• Atrial Fibrillation (diagnostic imaging, surgery)
• Catheter Ablation (adverse effects)
• Contrast Media
• Gadolinium
• Heart Atria (diagnostic imaging, surgery)
• Humans
• Magnetic Resonance Imaging
• Magnetic Resonance Spectroscopy
• Middle Aged