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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Left atrial appendage ligation in patients with atrial fibrillation leads to a decrease in atrial dispersion.

Mitsuharu Kawamura¹, Melvin M Scheinman¹, Randall J Lee¹

¹Section of Cardiac Electrophysiology, Division of Cardiology, University of California, San Francisco, San Francisco, CA (M.K., M.M.S., R.J.L., N.B.).

Journal of the American Heart Association

|May 16, 2015

Summary

This summary is machine-generated.

Left atrial appendage (LAA) ligation in atrial fibrillation (AF) patients shortens P-wave duration and reduces P-wave dispersion, suggesting reverse electrical remodeling and potentially maintaining sinus rhythm.

Keywords:

P wave atrial fibrillation atrial remodeling left atrial appendage ligation

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Area of Science:

Cardiology
Electrophysiology
Cardiac Surgery

Background:

Left atrial appendage (LAA) exclusion is used in atrial fibrillation (AF) to prevent cardioembolic events.
Left atrial electrical remodeling contributes to AF recurrence.
The impact of LAA exclusion on P-wave characteristics and atrial remodeling is not well understood.

Purpose of the Study:

To investigate the effect of LAA ligation on P-wave morphology in AF patients.

Main Methods:

Evaluated P-wave duration, amplitude, PQ interval, and dispersion before and after LAA ligation in 15 AF patients.
Patients were in sinus rhythm during the procedure.

Main Results:

P-wave duration significantly decreased post-ligation (P<0.05).
P-wave dispersion decreased significantly after 1-3 months (P=0.02).
PQ interval shortened immediately post-ligation (P=0.01).

Conclusions:

LAA exclusion leads to P-wave changes indicating reduced atrial mass and dispersion.
These changes may represent reverse electrical atrial remodeling.
LAA ligation might help maintain sinus rhythm in AF patients.