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      The Impact of Radiofrequency Wide Circumferential Pulmonary Vein Isolation on Left Atrial Geometry in Patients with Recurrent Atrial Fibrillation

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          Abstract

          Purpose: The aim of the study was to investigate the effect of wide area circumferential radiofrequency catheter ablation (WACA) pulmonary vein isolation on left atrium (LA) geometry. Methods: Seventy-one patients underwent WACA, for recurrent paroxysmal ( n = 31) and persistent ( n = 40) atrial fibrillation (AF). A three-dimension rotational angiography of the LA was obtained immediately prior to index and repeat procedure. Results: Significant reduction of LA volume (65.6 ± 14 mL/m<sup>2</sup> vs. 62.2 ± 15 mL/m<sup>2</sup>, p < 0.001) and surface (74.4 ± 11.2 vs. 70.4 ± 11.2 cm<sup>2</sup>/m<sup>2</sup>, p < 0.001) was noted. LA sphericity increased significantly (82 ± 2% vs. 83 ± 2%, p = 0.004) in all 71 patients. Patients with paroxysmal AF showed significant reduction of LA volume (121.8 ± 25.7 vs. 116 ± 32 mL, p = 0.008) and increase of LA sphericity (82.3 ± 2.1 vs. 83.1 ± 2%, p = 0.009). Patients with persistent AF showed significant decrease of LA volume (133.5 ± 32 vs. 126 ± 32 mL, p = 0.005) and LA surface area (76.3 ± 12.3 vs. 71.8 ± 12.4 cm<sup>2</sup>/m<sup>2</sup>, p = 0.005). LA sphericity (82.4 ± 2.8 vs. 83 ± 2.4%, p = ns) remained unchanged. Conclusions: WACA results into significant reduction of LA volume and surface area. Increased LA sphericity is observed in paroxysmal AF only.

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          Most cited references24

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          Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study

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            Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension: a possible beneficial effect of renin-angiotensin system inhibition on left atrial function

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              Effect of catheter ablation vs. antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2022
                October 2022
                03 June 2022
                : 147
                : 4
                : 436-442
                Affiliations
                Department of Cardiology, Cardiovascular Center OLV, Aalst, Belgium
                Author notes
                *Tom De Potter, tomdepotter@gmail.com
                Author information
                https://orcid.org/0000-0002-9815-8337
                Article
                525077 Cardiology 2022;147:436–442
                10.1159/000525077
                35661073
                38cace9a-12ba-413f-94f4-0b3b2c0e4124
                © 2022 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

                History
                : 06 November 2021
                : 20 April 2022
                Page count
                Figures: 2, Tables: 3, Pages: 7
                Funding
                Dr. Konstantinos E. Iliodromitis acknowledges funding received from the European Society of Cardiology in form of an ESC Research Grant – Grant reference No. T-2018 16555.
                Categories
                Electrophysiology and Arrhythmia: Research Article

                General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Atrial fibrillation,Three-dimension rotational angiography,Left atrial geometry,Radiofrequency ablation

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