Significant Improvement of Left Atrial and Left Atrial Appendage Function After Catheter Ablation for Persistent Atrial Fibrillation

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概要

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• Background: The long-term effects of catheter ablation (CA) on the left atrium and left atrial appendage (LAA) are unknown in persistent atrial fibrillation (AF). This study investigated left atrial (LA) reverse remodeling and evolution of LA/LAA function after successful CA for persistent AF and identified predictors for maintenance of sinus rhythm (SR) and LA reverse remodeling. Methods and Results: CA was performed in 123 patients with persistent AF. LA volumes, LA strain and LAA wall velocity were assessed both at baseline and at 12 months after ablation. Patients who maintained SR were divided into 2 groups according to whether LA volume decreased by ≥15% at follow-up (responders) or not (non-responders). During a follow-up period of 18±2 months, AF recurred in 45 patients (37%). Of the remaining 78 patients (63%) without recurrent AF, 62 patients (79%) were classified as responders. LA/LAA function significantly improved and the prevalence of spontaneous echo contrast decreased only in responders at follow-up. LA systolic strain and LAA wall velocity were independent predictors of both maintenance of SR (odds ratio [OR], 2.57; P=0.003; OR, 3.02; P=0.002, respectively) and LA reverse remodeling (OR, 4.44; P=0.007; OR, 3.52; P=0.01, respectively). Conclusions: Successful CA is associated with LA reverse remodeling and LA/LAA functional recovery in patients with persistent AF. LA systolic strain and LAA wall velocity at baseline predicted both maintenance of SR and LA reverse remodeling.

著者

• Tada Hiroshi

  Cardiology Department of Internal Medicine, Univercity of Tsukuba Graduate School of Comprehensive H

• Igarashi Miyako

  Cardiovascular division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Kawamura Ryo

  Cardiovacular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Yamasaki Hiro

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Machino Takeshi

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Sekiguchi Yukio

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Ishizu Tomoko

  Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Aonuma Kazutaka

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Seo Yoshihiro

  Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Kuroki Kenji

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Yamamoto Masayoshi

  Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Atsumi Akiko

  Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• Nakajima Hideki

  Department Of Biomolecular Engineering Tokyo Institute Of Technology

• YANAKA Satomi

  Department of Clinical Laboratory, Tsukuba University Hospital

• Nakajima Hideki

  Department of Clinical Laboratory, Tsukuba University Hospital

• Ishizu Tomoko

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Sekiguchi Yukio

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Machino-Ohtsuka Tomoko

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Koshino Yuki

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Igarashi Miyako

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

• Atsumi Akiko

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

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