Reverse structural left atrial remodeling and atrial tachycardia in patients with repeat ablation for atrial fibrillation
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Reverse structural left atrial remodeling and atrial tachycardia in patients with repeat ablation for atrial fibrillation. / Hashiguchi, Naotaka; Chiang, Cheng-Hung; Rottner, Laura; Reißmann, Bruno; Rillig, Andreas; Maurer, Tilman; Lemes, Christine; Kuck, Karl-Heinz; Ouyang, Feifan; Mathew, Shibu.
in: PACE, Jahrgang 46, Nr. 1, 01.2023, S. 11-19.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Reverse structural left atrial remodeling and atrial tachycardia in patients with repeat ablation for atrial fibrillation
AU - Hashiguchi, Naotaka
AU - Chiang, Cheng-Hung
AU - Rottner, Laura
AU - Reißmann, Bruno
AU - Rillig, Andreas
AU - Maurer, Tilman
AU - Lemes, Christine
AU - Kuck, Karl-Heinz
AU - Ouyang, Feifan
AU - Mathew, Shibu
N1 - © 2022 Wiley Periodicals LLC.
PY - 2023/1
Y1 - 2023/1
N2 - BACKGROUND: Catheter ablation has been evolved to a cornerstone in the therapy of atrial fibrillation (AF); however, atrial tachycardias (AT) after AF ablation are still an important issue. Besides the electrical recurrence of atrial tachyarrhythmia after ablation, left atrial (LA) remodeling has received attention as a consequence of AF.OBJECTIVE: The aim of this study is to evaluate predictors for AT recurrence and LA remodeling in patients with repeat AF ablation procedures.METHODS AND RESULTS: One hundred thirteen patients who underwent repeat AF ablation with 3D electro-anatomical mapping system were evaluated. Mean age was 63.1 ± 9.3 years, and 2.3 ± 0.5 ablation procedures were performed during a time period of 22 [IQR 7;48] months. Reverse structural LA remodeling (LA volume decreased more than 15%) was observed in 25 (22.1%) patients. LA volume index (LAVI) during first procedure was the only predictor for positive reverse structural LA remodeling (hazard ratio (HR): 1.03, 95% CI: 1.00-1.07, p = .036) in multivariate analysis. Fifty-nine (52.2%) patients experienced only AF and 54 (47.8%) patients AT after first procedure. Female gender (HR: 5.21, 95% CI: 1.66-18.08, p = .006), LAVI (HR: 1.06, 95% CI: 1.02-1.11, p = .008) and LA scar percentage (HR: 1.08, 95% CI: 1.02-1.17, p = .019) were independent significant predictors for AT recurrence in multivariate analysis.CONCLUSIONS: Reverse structural LA remodeling occurred in a quarter of patients with repeat ablation procedures for AF. Only larger LAVI during first procedure predicted reverse structural LA remodeling. Half of the patients experienced AT between first and last ablation procedure. Female gender, larger LAVI and larger scar area were significant predictors for AT after catheter ablation for AF.
AB - BACKGROUND: Catheter ablation has been evolved to a cornerstone in the therapy of atrial fibrillation (AF); however, atrial tachycardias (AT) after AF ablation are still an important issue. Besides the electrical recurrence of atrial tachyarrhythmia after ablation, left atrial (LA) remodeling has received attention as a consequence of AF.OBJECTIVE: The aim of this study is to evaluate predictors for AT recurrence and LA remodeling in patients with repeat AF ablation procedures.METHODS AND RESULTS: One hundred thirteen patients who underwent repeat AF ablation with 3D electro-anatomical mapping system were evaluated. Mean age was 63.1 ± 9.3 years, and 2.3 ± 0.5 ablation procedures were performed during a time period of 22 [IQR 7;48] months. Reverse structural LA remodeling (LA volume decreased more than 15%) was observed in 25 (22.1%) patients. LA volume index (LAVI) during first procedure was the only predictor for positive reverse structural LA remodeling (hazard ratio (HR): 1.03, 95% CI: 1.00-1.07, p = .036) in multivariate analysis. Fifty-nine (52.2%) patients experienced only AF and 54 (47.8%) patients AT after first procedure. Female gender (HR: 5.21, 95% CI: 1.66-18.08, p = .006), LAVI (HR: 1.06, 95% CI: 1.02-1.11, p = .008) and LA scar percentage (HR: 1.08, 95% CI: 1.02-1.17, p = .019) were independent significant predictors for AT recurrence in multivariate analysis.CONCLUSIONS: Reverse structural LA remodeling occurred in a quarter of patients with repeat ablation procedures for AF. Only larger LAVI during first procedure predicted reverse structural LA remodeling. Half of the patients experienced AT between first and last ablation procedure. Female gender, larger LAVI and larger scar area were significant predictors for AT after catheter ablation for AF.
KW - Humans
KW - Female
KW - Middle Aged
KW - Aged
KW - Atrial Fibrillation
KW - Atrial Remodeling
KW - Cicatrix
KW - Heart Atria/surgery
KW - Tachycardia, Supraventricular
KW - Catheter Ablation/methods
KW - Treatment Outcome
KW - Recurrence
U2 - 10.1111/pace.14619
DO - 10.1111/pace.14619
M3 - SCORING: Journal article
C2 - 36356298
VL - 46
SP - 11
EP - 19
JO - PACE
JF - PACE
SN - 0147-8389
IS - 1
ER -
