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Updated: Feb 13, 2026

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

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

Published on: February 26, 2013

心房細動アブレーションにおける両房ストレインへの影響：左房と右房の機能の違い

Shinichi Tachibana¹, Osamu Inaba¹, Yukihiro Inamura¹

¹Department of Cardiology, Japanese Red Cross Saitama Hospital, Shin-Toshin 1-5, Chu-ou-ku, Saitama, 330-8553, Japan.

|February 11, 2026

要旨

Background:

Catheter ablation for atrial fibrillation (AF) can improve atrial function; however, little is known about chamber-specific remodeling between the left (LA) and right (RA) atria.

Objective:

We investigated the differences in bi-atrial strain and its predictive value for atrial tachyarrhythmias (AF/AT) recurrence.

Methods:

We retrospectively analyzed the patients undergoing initial AF ablation who underwent pre- and post-procedural echocardiography. Atrial strain was quantified by two-dimensional speckle-tracking echocardiography.

Results:

Eighty-one patients were analyzed. Both the mean LA (LASr: 15.3 ± 10.0 to 19.9 ± 8.2%) and RA (RASr: 18.3 ± 10.8 to 27.3 ± 9.3%) reservoir strain improved significantly after AF ablation (P<0.001 for both), with a greater improvement in RASr than LASr (ΔRASr: 9.0 ± 10.7% vs. ΔLASr: 4.5 ± 8.4%, P<0.001). Moreover, whereas LA conduit strain did not change significantly (-9.3 ± 5.6 to -10.3 ± 4.4%, P=0.071), RA conduit strain improved significantly (-10.3 ± 6.3 to -14.1 ± 6.2%, P<0.001). Post-procedural LASr (HR 0.92, 95%CI: 0.85-1.0, P=0.049) and RASr (HR 0.94, 95%CI:0.89-0.99, P=0.016) were independent predictors of AF/AT recurrence. ROC analysis yielded similar discriminative ability for LASr (area under the curve (AUC): 0.75, cut-off value: 20.0%) and RASr (AUC: 0.69, cut-off value: 27.0%) (P=0.367).

Conclusion:

AF ablation led to significant bi-atrial functional recovery, with RA improvement exceeding that of LA. Both post-procedural LASr and RASr independently predicted AF/AT recurrence, supporting chamber-specific atrial strain as a sensitive marker of reverse remodeling and procedural outcome.

キーワード:

心房機能心房細動心房頻拍再発カテーテルアブレーション心エコー検査

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