Large left atrial appendage predicts the ablation outcome in hypertensive patients with atrial fibrillation

Du, Wei; Dai, Min; Wang, Min; Gong, Qian; Ye, Ting-Qiao; Hu, Wang; Luo, Caidong

doi:10.1016/j.jelectrocard.2020.07.017

Cited by 8 publications

(11 citation statements)

References 29 publications

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“…The meta-analysis comprised thirteen ( 17 , 18 , 20 , 22 , 24 – 32 ) studies that evaluated the risk of AF recurrence following CA based on LAA volume in 2741 people. LAA volume was assessed using computed tomography (CT) in most studies while one study used transesophageal echocardiography (TEE).…”

Section: Resultsmentioning

confidence: 99%

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Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies

Han

Liu

Jia

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe results of studies evaluating the left atrial appendage (LAA) function and structure as predictors of atrial fibrillation (AF) recurrence after catheter ablation (CA) are contradictory. Therefore, we performed a meta-analysis to assess whether the LAA function and structure can predict the recurrence of AF after CA.MethodsThe PubMed, EMBASE, Web of Science, and Cochrane library databases were used to conduct a comprehensive literature search. Finally, 37 studies encompassing 11 LAA parameters were included in this meta-analysis.ResultsCompared with those in the non-recurrence group, the recurrence group had increased LAA volume (SMD 0.53, 95% CI [0.36, 0.71] p < 0.00001), LAA volume index, LAA orifice area, and LAA orifice short/long axis and decreased LAA emptying flow velocity (SMD -0.54, 95% CI [-0.68, -0.40], P < 0.00001), LAA filling flow velocity, and LAA ejection fraction, while there was no significant difference in LAA morphology or LAA depth.ConclusionLarge LAA structure of pre-ablation (LAA volume, orifice area, orifice long/short axis, and volume index) and decreased LAA function of pre-ablation (LAA emptying flow velocity, filling flow velocity, ejection fraction, and LASEC) increase the odds of AF recurrence after CA.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022324533].

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Section: Resultsmentioning

confidence: 99%

“…However, there is disagreement on the LAA structure and function in predicting AF recurrence after CA ( 16 – 18 ). Therefore, this meta-analysis was conducted to determine whether LAA structure and function can predict the recurrence of AF after CA in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies

Han

Liu

Jia

et al. 2022

Front. Cardiovasc. Med.

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“…We identified that eQTLs specific to the heart atrial appendage make a reproducible and substantial (second highest) contribution to the risk of developing PD. The heart atrial appendage is a trigger site of atrial fibrillation (AF) ( Di Biase et al, 2010 ) and highly associated with hypertension and stroke ( Hart and Halperin, 2001 ; Stöllberger et al, 2003 ; Turagam et al, 2018 ; Du et al, 2020 ). Notably, none of the heart atrial appendage eQTLs we identified have been previously associated with cardiac health or atrial fibrillation by GWAS (GWAS catalog, November 2, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Machine Learning Identifies Six Genetic Variants and Alterations in the Heart Atrial Appendage as Key Contributors to PD Risk Predictivity

Schierding

Farrow

et al. 2022

Front. Genet.

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Parkinson’s disease (PD) is a complex neurodegenerative disease with a range of causes and clinical presentations. Over 76 genetic loci (comprising 90 SNPs) have been associated with PD by the most recent GWAS meta-analysis. Most of these PD-associated variants are located in non-coding regions of the genome and it is difficult to understand what they are doing and how they contribute to the aetiology of PD. We hypothesised that PD-associated genetic variants modulate disease risk through tissue-specific expression quantitative trait loci (eQTL) effects. We developed and validated a machine learning approach that integrated tissue-specific eQTL data on known PD-associated genetic variants with PD case and control genotypes from the Wellcome Trust Case Control Consortium. In so doing, our analysis ranked the tissue-specific transcription effects for PD-associated genetic variants and estimated their relative contributions to PD risk. We identified roles for SNPs that are connected with INPP5P, CNTN1, GBA and SNCA in PD. Ranking the variants and tissue-specific eQTL effects contributing most to the machine learning model suggested a key role in the risk of developing PD for two variants (rs7617877 and rs6808178) and eQTL associated transcriptional changes of EAF1-AS1 within the heart atrial appendage. Similarly, effects associated with eQTLs located within the Brain Cerebellum were also recognized to confer major PD risk. These findings were replicated in two additional, independent cohorts (the UK Biobank, and NeuroX) and thus warrant further mechanistic investigations to determine if these transcriptional changes could act as early contributors to PD risk and disease development.

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“…LAA dimensions may also influence TE risk. Accordingly, some authors have observed that LAA volume (larger than 8.8ml according to Zheng et al, and >9.99 ml by Du et al) increases the likelihood of AF recurrences after antral RF ablation [40,41]. Furthermore, Patel et al and Demir et al demonstrated that 30,4% of all patients that underwent CT scan before ablation procedure had atypical left atrial anatomy (diverticula or accessory appendages) [42,43] (Fig.…”

Section: Left Atrial Appendagementioning

confidence: 99%

Atrial fibrillation ablation: the position of computed tomography in pre-procedural imaging

Stachyra

Główniak

Czekajska-Chehab

2022

Current Issues in Pharmacy and Medical Sciences

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Atrial fibrillation (AF) is the most common supraventricular arrhythmia. Despite significant advances in its treatment, it still remains one of the leading causes of cardiovascular morbidity and mortality. In the last two decades, pulmonary vein isolation (PVI) was developed as the most effective treatment option. The reported effectiveness of a single ablation procedure ranges from 40% to 69% with single, and up to 88% with repeated procedures, with acceptable safety profile. The PubMed database was searched, using terms including ‘atrial fibrillation ablation’, ‘pulmonary vein isolation’, ‘computed tomography’, ‘pulmonary vein anatomy’ and ‘ovality index’. Papers were reviewed for relevance and scientific merit. Different imaging techniques are used for pre-procedural assessment of left atrial (LA) anatomy, of which computed tomography (CT) is the most common. It allows assessing pulmonary vein (PV) anatomy, the LA wall thickness in different regions and the left atrial appendage (LAA) anatomy, together with excluding the presence of intracardiac thrombi. Pre-procedural PVs imaging is important regardless of the selected ablation technique, however, cryoballoon (CB) ablation seems to be particularly anatomy-dependent. Additionally, CT also permits assessment of several PVs characteristics (geometry, dimensions, angulations, the ostium area, orientation and ovality index (OI), which are essential for the patients’ qualification and designing the strategy of AF ablation. In this paper, we have reviewed the role of CT imaging in patients undergoing ablation procedure due to recurrent/symptomatic atrial fibrillation. Moreover, we discussed the relevant literature.

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Large left atrial appendage predicts the ablation outcome in hypertensive patients with atrial fibrillation

Cited by 8 publications

References 29 publications

Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies

Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies

Machine Learning Identifies Six Genetic Variants and Alterations in the Heart Atrial Appendage as Key Contributors to PD Risk Predictivity

Atrial fibrillation ablation: the position of computed tomography in pre-procedural imaging

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