Changes in left atrial structure and function after catheter ablation and electrical cardioversion for atrial...

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Imaging

Background:

• Atrial fibrillation (AF) leads to left atrial (LA) structural and functional changes.
• Catheter ablation (ABL) and electrical cardioversion (ECV) are common AF treatments.
• Understanding post-treatment LA remodeling is crucial for patient management.

Purpose of the Study:

• To compare morphological and functional left atrial (LA) changes after catheter ablation (ABL) versus electrical cardioversion (ECV) in atrial fibrillation (AF) patients.
• To assess the recovery of LA dimensions and function post-ABL and post-ECV.

Main Methods:

• Prospective study of 63 AF patients maintaining sinus rhythm for 3 months post-ECV (n=30) or ABL (n=33).
• Serial 2D and Doppler echocardiography at baseline, 1 week, 1 month, and 3 months.
• Evaluation of LA dimensions, mitral inflow velocity, and mitral annular tissue Doppler imaging.

Main Results:

• Both ABL and ECV resulted in decreased LA dimensions.
• Mean late mitral annular velocity increased in both groups from 1 week to 3 months.
• Mean late transmitral peak velocity significantly increased post-ECV but not post-ABL.

Conclusions:

• Successful ABL and ECV induce reverse morphological remodeling of the left atrium (LA) in AF patients.
• Left atrial (LA) function recovery is delayed up to 3 months post-ABL compared to ECV.
• Meticulous anticoagulation is recommended following ABL due to slower LA functional recovery.