The Association of Left Atrial Appendage Morphology to Atrial Fibrillation Recurrence After Radiofrequency Ablation

Gong, Shaoming; Zhou, Jian; Li, Bingyu; Kang, Sheng; Ma, Xiaoxiao; Cai, Ying; Guo, Ye; Hu, Rui; Zhang, Xumin

doi:10.3389/fcvm.2021.677885

Cited by 12 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Optimal patient selection is of high importance in light of considerable AF recurrence and potential procedural complications (7). Numerous predictors of AF recurrence have been described, such as hypertension, left atrial (LA) enlargement, particular pulmonary vein (PV) anatomical variations, and certain left atrial appendage (LAA) morphologies (8)(9)(10)(11)(12). The role of both the LAA and PV anatomical variations in the efficacy of PVI procedures is verified by previous studies.…”

Section: Introductionmentioning

confidence: 79%

Abutting Left Atrial Appendage and Left Superior Pulmonary Vein Predicts Recurrence of Atrial Fibrillation After Point-by-Point Pulmonary Vein Isolation

Szegedi

Simon

Szilveszter

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionThe role of the spatial relationship between the left superior pulmonary vein (LSPV) and left atrial appendage (LAA) is unknown. We sought to evaluate whether an abutting LAA and LSPV play a role in AF recurrence after catheter ablation for paroxysmal AF.MethodsConsecutive patients, who underwent initial point-by-point radiofrequency catheter ablation for paroxysmal AF at the Heart and Vascular Center of Semmelweis University, Budapest, Hungary, between January of 2014 and December of 2017, were enrolled in the study. All patients underwent pre-procedural cardiac CT to assess left atrial (LA) and pulmonary vein (PV) anatomy. Abutting LAA-LSPV was defined as cases when the minimum distance between the LSPV and LAA was less than 2 mm.ResultsWe included 428 patients (60.7 ± 10.8 years, 35.5% female) in the analysis. AF recurrence rate was 33.4%, with a median recurrence-free time of 21.2 (8.8–43.0) months. In the univariable analysis, female sex (HR = 1.45; 95%CI = 1.04–2.01; p = 0.028), LAA flow velocity (HR = 1.01; 95%CI = 1.00–1.02; p = 0.022), LAA orifice area (HR = 1.00; 95%CI = 1.00–1.00; p = 0.028) and abutting LAA-LSPV (HR = 1.53; 95%CI = 1.09–2.14; p = 0.013) were associated with AF recurrence. In the multivariable analysis, abutting LAA-LSPV (adjusted HR = 1.55; 95%CI = 1.04–2.31; p = 0.030) was the only independent predictor of AF recurrence.ConclusionAbutting LAA-LSPV predisposes patients to have a higher chance for arrhythmia recurrence after catheter ablation for paroxysmal AF.

show abstract

Section: Introductionmentioning

confidence: 79%

Abutting Left Atrial Appendage and Left Superior Pulmonary Vein Predicts Recurrence of Atrial Fibrillation After Point-by-Point Pulmonary Vein Isolation

Szegedi

Simon

Szilveszter

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…Table 1 displayed the study characteristics of 16 included studies, comprising 9 ( 12 , 15 , 18 , 20 , 21 , 23 – 25 , 27 ) prospective studies and 7 ( 13 , 14 , 16 , 17 , 19 , 22 , 26 ) retrospective studies. Six studies ( 19 , 22 – 25 , 27 ) were conducted in China, 4 studies ( 15 , 16 , 20 , 21 ) in Japan, 2 studies ( 14 , 17 ) in Hungary, 1 study ( 26 ) in South Korea, 1 study ( 13 ) in Poland, 1 study ( 12 ) in Türkiye, and 1 study ( 18 ) in Romania. Sixteen studies with 5,006 AF patients after CA (1,479 patients with AF recurrence, 3,527 without AF recurrence) were included, and the proportion of AF patients with recurrence ranged from 24.1 to 41.5%.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age ranged from 54.6 ± 10.4 to 67.5 ± 7.5 years, and the median follow-up time varied from 6 to 48 months. Nine ( 12 – 15 , 17 , 18 , 22 , 23 , 25 ) studies performed circumferential pulmonary vein isolation (CPVI) alone, whereas 7 ( 16 , 19 – 21 , 24 , 26 , 27 ) studies conducted additional linear ablations. The LAAFV, which refers to the peak flow emptying velocity of the left atrial appendage at late diastole, was measured by transthoracic echocardiography (TEE) in all selected research.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies ( 12 – 15 , 17 – 27 ) reported the relationship between LAAFV values and the risk of AF recurrence after CA. Nine studies ( 14 , 17 – 19 , 21 , 23 – 26 ) (11 data sets) defined LAAFV as continuous variables, and the pooled analysis showed that for every 1cm/s rise in LAAFV values, the risk of AF recurrence after CA decreased by 3% [OR:0.97, 95% CI: 0.95 to 0.99, P < 0.01; I 2 = 91.4% Figure 3 ]. The sensitivity analysis results were consistent (OR: 0.96 to 0.98, p all < 0.05, Supplementary Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Left atrial appendage flow velocity predicts recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis

Chen

Shi

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

PurposeThere is increasing evidence that left atrial appendage flow velocity (LAAFV) is linked to the recurrence of atrial fibrillation (AF) after catheter ablation (CA), suggesting the potential predictable significance of LAAFV in this setting. We performed a systematic review and meta-analysis to assess whether LAAFV is association with AF recurrence after CA.MethodsUp to May 1, 2022, six databases (PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and CINAHL) were searched for literature reporting the association between LAAFV and AF recurrence after CA. All statistical analyses were carried out using STATA version 16 software. Heterogeneity was determined by the Cochrane’s Q test and I2 statistics. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of each included study, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was adopted to evaluate the quality of evidence.ResultSixteen studies with 5,006 AF patients after CA (1,479 patients with AF recurrence, 3,527 without AF recurrence) were included in the meta-analysis. The meta-analysis of 15 studies (16 data sets) showed that patients with recurrence exhibited lower LAAFV values than those without recurrence [standardized mean difference (SMD): −0.65, 95% CI: −0.88 to −0.42, P < 0.01]. Moreover, we evaluated the association of LAAFV and the risk of AF recurrence after CA. Nine studies (11 data sets) defined LAAFV as continuous variables, and the pooled analysis suggested that for every 1 cm/s rise in LAAFV values, the risk of AF recurrence after CA decreased by 3% [Odds Ratio (OR): 0.97, 95% CI: 0.95 to 0.99, P < 0.01]. Seven studies defined LAAFV as categorical variables, and the pooled analysis showed that lower LAAFV were associated with an increased risk of AF recurrence after CA [OR: 2.28, 95% CI: 1.46 to 3.57, P < 0.01]. The subgroup analyses showed that the association between LAAFV and AF recurrence after CA was not significantly affected by the AF type and ablation procedure. The NOS indicated that included studies were moderate to high quality, while the GRADE assessment suggested a low certainty of the evidence.ConclusionLower LAAFV may be associated with an increased risk of AF recurrence after CA. Further studies with well designed and randomized studies for LAAFV should be conducted.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022333627].

show abstract

“…By taking preoperative and intraoperative realtime measurements of cardiac structures, TEE may provide surgical guidance in congenital heart disease, 75 atrioventricular septal defects, 76,77 transcatheter aortic valve replacement (TAVR) 78 and left atrial appendage (LAA) closure, 79 and predict postoperative complications. 75,80 Further, real-time 3D-TEE optimizes the spatial and temporal resolution and enables an en face view, thereby significantly enhancing the visualization of a complex 3D structure. Deng et al 81 used 3D-TEE to evaluate the atrial septal defect preoperatively and accurately and systematically characterized the residual edge of the complex atrial septal defect.…”

Section: Echocardiographymentioning

confidence: 99%

The Chinese Experience of Imaging in Cardiac Intervention

Liu

Yang

Chen

2022

Journal of Thoracic Imaging

View full text Add to dashboard Cite

Recent scientific and technological advances have greatly contributed to the development of medical imaging that could enable specific functions. It has become the primary focus of cardiac intervention in preoperative assessment, intraoperative guidance, and postoperative follow-up. This review provides a contemporary overview of the Chinese experience of imaging in cardiac intervention in recent years.

show abstract

The Association of Left Atrial Appendage Morphology to Atrial Fibrillation Recurrence After Radiofrequency Ablation

Cited by 12 publications

References 34 publications

Abutting Left Atrial Appendage and Left Superior Pulmonary Vein Predicts Recurrence of Atrial Fibrillation After Point-by-Point Pulmonary Vein Isolation

Abutting Left Atrial Appendage and Left Superior Pulmonary Vein Predicts Recurrence of Atrial Fibrillation After Point-by-Point Pulmonary Vein Isolation

Left atrial appendage flow velocity predicts recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis

The Chinese Experience of Imaging in Cardiac Intervention

Contact Info

Product

Resources

About