Top

Journal of Interventional Cardiac Electrophysiology

Published in:

01-11-2015

Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

Authors: Takahiko Nagase, Ritsushi Kato, Shintaro Nakano, Yuichirou Shiki, Sayaka Tanaka, Yoshifumi Ikeda, Shiro Iwanaga, Shigeyuki Nishimura, Kazuo Matsumoto

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2015

Abstract

Purpose

Although left atrial function index is reportedly a possible predictor of hospitalization for heart failure and of stroke irrespective of the presence or not of atrial fibrillation (AF), the effects of catheter ablation on left atrial function index have not yet been reported.

Methods

We performed catheter ablation on 55 patients (age 56.6 ± 9.6 years; 44 men; 30 with paroxysmal and 25 with persistent, long-standing AF) and evaluated them by transthoracic echocardiography preoperatively and 3 monthly for 12–24 months after catheter ablation. We then compared clinical characteristics and echocardiographic variables before catheter ablation between two groups: the 42 subjects with the most recent left atrial function index <30 and the 13 in which it was ≥30.

Results

Left atrial function index improved after catheter ablation in both groups, plateauing 6 months after the procedure. Univariate analysis showed statistically significant differences in the prevalence of chronic AF and left atrial emptying fraction, diameter, and maximum and minimum volume (prevalence of chronic AF, p < 0.05; others, p < 0.01) between the groups. Multivariate analysis showed that only maximum left atrial volume predicts left atrial function index after catheter ablation (p < 0.05). In addition, we used ROC analysis to calculate a cutoff value for LA maximum volume as a good predictor and found that a good cutoff value was 63.5 mL, the sensitivity and specificity being 0.75 and 0.75, respectively.

Conclusions

Catheter ablation improves left atrial function index. However, in patients with left atrial maximum volume of over 63.5 mL on echocardiography, the index did not recover to within the normal range after catheter ablation.

Verma, A., Kilicaslan, F., Adams, J. R., Hao, S., Beheiry, S., Minor, S., et al. (2006). Extensive ablation during pulmonary vein antrum isolation has no adverse impact on left atrial function: an echocardiography and cine computed tomography analysis. Journal of Cardiovascular Electrophysiology, 17(7), 741–746.CrossRefPubMed

Reant, P., Lafitte, S., Jaïs, P., Serri, K., Weerasooriya, R., Hocini, M., et al. (2005). Reverse remodeling of the left cardiac chambers after catheter ablation after 1 year in a series of patients with isolated atrial fibrillation. Circulation, 112(19), 2896–2903.PubMed

Kucukdurmaz, Z., Kato, R., Erdem, A., Golcuk, E., Tobiume, T., Nagase, T., et al. (2013). Catheter ablation for atrial fibrillation results in greater improvement in cardiac function in patients with low versus normal left ventricular ejection fraction. Journal of Interventional Cardiovascular Electrophysiology, 37(2), 179–187.CrossRef

Bunch, T. J., May, H. T., Bair, T. L., Weiss, J. P., Crandall, B. G., Osborn, J. S., et al. (2013). Atrial fibrillation ablation patients have long-term stroke rates similar to patients without atrial fibrillation regardless of CHADS2 score. Heart Rhythm, 10(9), 1272–1277.CrossRefPubMed

Weerasooriya, R., Khairy, P., Litalien, J., Macle, L., Hocini, M., Sacher, F., et al. (2011). Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? Journal of the American College of Cardiology, 57(2), 160–166.CrossRefPubMed

Wong, J. M., Welles, C. C., Azarbal, F., Whooley, M. A., Shiller, N. B., & Turakhia, M. P. (2014). Relation of left atrial dysfunction to ischemic stroke in patients with coronary heart disease (from the Heart and Soul Study). The American Journal of Cardiology, 113(10), 1679–1684.CrossRefPubMed

Welles, C. C., Ku, I. A., Kwan, D. M., Whooley, M. A., & Schiller, N. B. (2012). Left atrial function predicts heart failure hospitalization in subjects with preserved ejection fraction and coronary heart disease: longitudinal data from the Heart and Soul Study. Journal of the American College of Cardiology, 59(7), 673–680.CrossRefPubMedCentralPubMed

Thomas, L., Hoy, M., Byth, K., & Schiller, N. B. (2008). The left atrial function index: a rhythm independent marker of atrial function. European Journal of Echocardiography, 9(3), 356–362.PubMed

The Stroke Prevention in Atrial Fibrillation Investigators Committee on Echocardiography. (1998). Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation. Annals of Internal Medicine, 128(8), 639–647.CrossRef

10.

Sakurai, K., Hirai, T., Nakagawa, K., Kameyama, T., Nozawa, T., Asanoi, H., et al. (2003). Left atrial appendage function and abnormal hypercoagulability in patients with atrial flutter. Chest Journal, 124(5), 1670–1674.CrossRef

11.

Manning, W. J., Leeman, D. E., Gotch, P. J., & Come, P. C. (1989). Pulsed Doppler evaluation of atrial mechanical function after electrical cardioversion of atrial fibrillation. Journal of the American College of Cardiology, 13(3), 617–623.CrossRefPubMed

12.

Thomas, L., Levett, K., Boyd, A., Leung, D. Y., Schiller, N. B., & Ross, D. L. (2003). Changes in regional left atrial function with aging: evaluation by Doppler tissue imaging. European Journal of Echocardiography, 4(2), 92–100.CrossRefPubMed

13.

Atrial Fibrillation Investigators. (1998). Echocardiographic predictors of stroke in patients with atrial fibrillation: a prospective study of 1066 patients from 3 clinical trials. Archives of Internal Medicine, 158(12), 1316–1320.CrossRef

14.

The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. (1998). Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study. The Journal of the American Medical Association, 279(16), 1273–1277.CrossRef

15.

Kannel, W. B., Abbott, R. D., Savage, D. D., & McNamara, P. M. (1982). Epidemiologic features of chronic atrial fibrillation: the Framingham Study. The New England Journal of Medicine, 306(17), 1018–1122.CrossRefPubMed

16.

Khan, I. A. (2003). Atrial stunning: basics and clinical considerations. International Journal of Cardiology, 92(2–3), 113–128.CrossRefPubMed

17.

Hof, I., Arbab-zadeh, A., Scherr, D., Chilukuri, K., Dalal, D., Abraham, T., et al. (2009). Correlation of left atrial diameter by echocardiography and left atrial volume by computed tomography. Journal of Cardiovascular Electrophysiology, 20(2), 59–163.CrossRef

18.

Avelar, E., Durst, R., Rosito, G. A., Thangaroopan, M., Kumar, S., Tournoux, F., et al. (2010). Comparison of the accuracy of multidetector computed tomography versus two-dimensional echocardiography to measure left atrial volume. The American Journal of Cardiology, 106(1), 104–109.CrossRefPubMed

19.

Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18(12), 1440–1463.CrossRefPubMed

20.

Kohári, M., Zado, E., Marchlinski, F. E., Callans, D. J., & Han, Y. (2014). Left atrial volume best predicts recurrence after catheter ablation in patients with persistent and longstanding persistent atrial fibrillation. Pacing and Clinical Electrophysiology, 37(4), 422–429.CrossRefPubMed

21.

Abecasis, J., Dourado, R., Ferreira, A., Saraiva, C., Cavaco, D., Santos, K. R., et al. (2009). Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Europace, 11(10), 1289–1294.CrossRefPubMed

22.

Parikh, S. S., Jons, C., Mcnitt, S., Daubert, J. P., Schwarz, K. Q., & Hall, B. (2010). Predictive capability of left atrial size measured by CT, TEE, and TTE for recurrence of atrial fibrillation following radiofrequency catheter ablation. Pacing and Clinical Electrophysiology, 33(5), 532–540.CrossRefPubMed

23.

Järvinen, V., Kupari, M., Hekali, P., & Poutanen, V. P. (1994). Assessment of left atrial volumes and phasic function using cine magnetic resonance imaging in normal subjects. The American Journal of Cardiology, 73(15), 1135–1138.CrossRefPubMed

24.

Ariyama, M., Kato, R., Matsumura, M., Yoshimoto, H., Nakajima, Y., Nakano, S., et al. (2015). Left atrial appendage wall-motion velocity associates with recurrence of nonparoxysmal atrial fibrillation after catheter ablation. Echocardiography, 32(2), 272–280.CrossRefPubMed

25.

Bunch, T. J., Crandall, B. G., Weiss, J. P., May, H. T., Bair, T. L., Osboron, J. S., et al. (2011). Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation. Journal of Cardiovascular Electrophysiology, 22(8), 839–845.CrossRefPubMed

26.

Hsu, L. F., Jaïs, P., Sanders, P., Garrigue, S., Hocini, M., Sacher, F., et al. (2004). Catheter ablation for atrial fibrillation in congestive heart failure. The New England Journal of Medicine, 351(23), 2373–2383.CrossRefPubMed

27.

Calkins, H., Brugada, J., Packer, D. L., Cappato, R., Chen, S. A., Crijns, H. J., et al. (2007). HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm, 4(6), 816–861.CrossRefPubMed

Title: Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation
Authors: Takahiko Nagase
Ritsushi Kato
Shintaro Nakano
Yuichirou Shiki
Sayaka Tanaka
Yoshifumi Ikeda
Shiro Iwanaga
Shigeyuki Nishimura
Kazuo Matsumoto
Publication date: 01-11-2015
Publisher: Springer US
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 2/2015
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-015-0043-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2015

Reappraisal of the clinical implications of adenosine triphosphate in terms of the prediction of reconnection sites in cases with electrical isolation of the pulmonary veins

Impact of catheter ablation with remote magnetic navigation on procedural outcomes in patients with persistent and long-standing persistent atrial fibrillation

Comparison of the anterior and posterior mitral isthmus ablation lines in patients with perimitral annulus flutter or persistent atrial fibrillation

Longevity of implantable cardioverter-defibrillators in a single-center population

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy patients: a systematic review

Bleeding risks with novel oral anticoagulants during catheter ablation of atrial fibrillation: a systematic review and network meta-analysis