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Updated: Sep 21, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Low left atrial appendage emptying velocity is a predictor of atrial fibrillation recurrence after catheter ablation
Sahith Reddy Thotamgari1, Aakash Rajendra Sheth1, Javaria Ahmad1
1Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Insights
Left atrial appendage emptying velocity, measured by transesophageal echocardiogram, can predict atrial fibrillation recurrence after catheter ablation. Higher velocities indicate a lower risk of recurrence post-procedure.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Atrial fibrillation (AF) recurrence after catheter ablation (CA) is common, with annual rates of 5%-9%.
- Predictive markers for AF recurrence post-CA are crucial for patient management.
- Left atrial appendage (LAA) function is implicated in AF pathophysiology.
Purpose of the Study:
- To evaluate left atrial appendage (LAA) emptying velocity derived from echocardiography as a predictor of AF recurrence after CA.
- To determine if LAA emptying velocity can identify patients at higher or lower risk of AF recurrence post-ablation.
Main Methods:
- A study included 303 consecutive patients undergoing CA for AF from 2014-2020.
- Transesophageal echocardiogram (TEE) was used to measure LAA emptying velocities.
- Statistical analyses, including logistic regression and ROC curves, were employed to assess the predictive value of LAA velocity.
Main Results:
- A total of 103 patients (40%) experienced AF recurrence post-CA.
- LAA emptying velocity ≥52.3 cm/s was significantly associated with decreased AF recurrence (OR: 0.55; 95% CI: 0.31-0.97; p=0.03).
- In patients in normal sinus rhythm during TEE, this association remained significant (OR: 0.35; 95% CI: 0.15-0.82; p=0.01).
Conclusions:
- Preprocedural LAA emptying velocity measured by TEE is a valuable predictor of AF recurrence following CA.
- This echocardiographic parameter can aid in risk stratification for patients undergoing AF ablation.
Background:
Recurrence of atrial fibrillation (AF) after catheter ablation (CA) remains common and studies have shown about 5%-9% annual recurrence rate after CA. We sought to assess the echocardiogram derived left atrial appendage (LAA) emptying velocity as a predictor of AF recurrence after CA.
Objective:
To determine if LAA emptying is a marker of recurrence of AF post-CA METHODS: A total of 303 consecutive patients who underwent CA for AF between 2014 and 2020 were included. Baseline clinical characteristics and echocardiographic data of the patients were obtained by chart review. LAA emptying velocities were obtained from transesophageal echocardiogram (TEE). LA voltage was obtained during the mapping for CA. Chi-square test and nominal logistic regression were used for statistical analysis. An receiver operator characteristic curve was used to determine LAA velocity cut-off.
Results:
Mean patient age was 61.7 ± 10.5; 32% were female. Mean LAA emptying velocity was 47.5 ± 20.2. A total of 103 (40%) patients had recurrence after CA. In the multivariable model, after adjusting for potential confounders, LAA emptying velocity of ≥52.3 was associated with decreased AF recurrence postablation (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.31-0.97; p = .03*). There were 190 (73%) patients in normal sinus rhythm during TEE and CA, and sensitivity analysis of these patients showed that LAA velocity ≥52.3 remained associated with decreased AF recurrence (OR: 0.35; 95% CI: 0.15-0.82; p = .01*).
Conclusion:
LAA emptying velocity measured during preprocedural TEE can serve as a predictor of AF recurrence in patients undergoing CA.
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