Left Atrial Size and Left Ventricular End‐Systolic Dimension Predict the Progression of Paroxysmal Atrial Fibrillation After Catheter Ablation

Abstract

RF ablation prevents the progression of paroxysmal AF effectively, except in patients with increased LA diameter and LV end-systolic diameter on echocardiogram, suggesting more aggressive rhythm control therapies should be considered in these patients.

Elevated β1-Adrenergic Receptor Autoantibody Levels Increase Atrial Fibrillation Susceptibility by Promoting Atrial Fibrosis

“…Fibrosis is an important part of atrial remodeling in AF, and an increased LA diameter is a simple indicator of severe atrial structural remodeling and interstitial fibrosis or scarring (Liao et al, 2017). In addition, left atrium enlargement is the pathological basis and a major determinant of AF and its progression.…”

Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment

“…Among patients with AF who undergo ablation, those who have increased LA dimensions, pressures or fibrosis, or LV fibrosis or abnormal diastolic filling parameters are at increased risk for AF recurrence and often require repeated ablation procedures; in patients without a prior myocardial infarction (i.e. HFpEF), the finding of ventricular fibrosis doubles the procedural failure rate .…”

“…34,39 Unfortunately, patients with AF who have myocardial fibrosis are unlikely to maintain sinus rhythm following an ablation procedure; 227,228 this is likely to explain the high rate of AF recurrence following catheter ablation in patients with obesity or type 2 diabetes. [229][230][231][232][233][234] Among patients with AF who undergo ablation, those who have increased LA dimensions, pressures or fibrosis, or LV fibrosis or abnormal diastolic filling parameters are at increased risk for AF recurrence and often require repeated ablation procedures; 227,228,[232][233][234][235][236][237][238][239][240] in patients without a prior myocardial infarction (i.e. HFpEF), the finding of ventricular fibrosis doubles the procedural failure rate.…”

Treatment Strategies for Atrial Fibrillation With Left Ventricular Systolic Dysfunction ― Meta-Analysis ―

“…LV performance is an important factor predicting post-ablation outcome. 36 Both systolic and diastolic dysfunction recover, leading to ventricular volume reduction after SR conversion by CA. 27,35 In the present study, exercise capacity measured using 6MWD improved significantly in the CA group, and probably reflected structural as well as functional recovery.…”