Related Experiment Video
Updated: Sep 13, 2025
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Prognostic impact of E- and A-wave adjacency after atrial fibrillation ablation
Jumpei Saito1, Kato Daiki2, Sato Hirotoshi2
1Division of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan. saijun0960@hotmail.co.jp.
Insights
E- and A-wave adjacency on echocardiography predicts atrial arrhythmia recurrence after AF ablation. Shorter overlap length indicates a lower risk of recurrent arrhythmias, suggesting its utility in post-ablation management.
Area of Science:
- Cardiology
- Echocardiography
- Electrophysiology
Background:
- Echocardiographic E- and A-wave adjacency in systolic heart failure correlates with better outcomes.
- The significance of this echocardiographic finding in atrial fibrillation (AF) patients post-ablation is not well understood.
Purpose of the Study:
- To investigate the relationship between E- and A-wave adjacency, assessed post-ablation, and the recurrence of atrial arrhythmias (AR) in patients who underwent AF ablation.
Main Methods:
- 175 patients undergoing first-time AF ablation were included.
- Transthoracic echocardiography was performed the day after ablation to measure E- and A-wave overlap length.
- Statistical analysis correlated overlap length with AR recurrence.
Main Results:
- Prolonged E- and A-wave overlap length was significantly associated with higher AR rates (P < .001).
- Patients without prolonged overlap had a significantly lower AR rate (HR, 0.15; P < .001).
- Findings were consistent across all AF types.
Conclusions:
- E- and A-wave adjacency length is a significant predictor of AR following AF ablation.
- This echocardiographic parameter may aid in risk stratification for patients post-AF ablation.
Background:
In adult patients with systolic heart failure, the presence of adjacent, nonoverlapping E and A waves on Doppler echocardiography is associated with optimal cardiac output and favorable clinical outcomes. However, the clinical significance of echocardiographic adjacency in patients with atrial fibrillation (AF) remains uncertain. We aimed to explore the relationship between E- and A-wave adjacency assessed the day after catheter ablation and the recurrence of atrial arrhythmias (AR) following AF ablation.
Methods:
This study included patients with AF who underwent first-time arrhythmia ablation. Transthoracic echocardiography was performed on the day following catheter ablation to evaluate the presence of E- and A-wave adjacency. The relationship between overlap length and recurrence of AR after AF ablation was analyzed.
Results:
The study included 175 patients (124 males; mean age: 68 [range 52-79] years; mean CHA2DS2-Vasc score: 2 [range 0-4]; and 93 with paroxysmal AF) who underwent AF ablation. There were no significant differences between the two groups in terms of heart failure history or echocardiographic parameters prior to catheter ablation. However, the absolute overlap length was significantly prolonged in the AR group (59 [range 9-160] msec vs. 120 [range 28.6-226] msec; P < .001). Furthermore, the AR rate was significantly lower in the group without prolonged overlap length (hazard ratio, 0.15 [95% confidence interval, 0.07-0.30]; P < .001). These findings were consistent across all AF types.
Conclusions:
The length of E- and A-wave adjacency appears to be a significant predictor of AR following AF ablation.
