Short- and long-term associations of atrial fibrillation catheter ablation with left atrial structure and function: A cardiac magnetic resonance study

Mohammadali Habibi, Joao A.C. Lima, Esra Gucuk Ipek, David D Spragg, Hiroshi Ashikaga, Joseph E. Marine, Ronald D. Berger, Hugh Calkins, Saman Nazarian

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The effects of atrial fibrillation (AF) catheter ablation on the left atrium (LA) are poorly understood. Objectives: To examine short- and long-term associations of AF catheter ablation with LA function using cardiac magnetic resonance (CMR). Methods: Fifty-one AF patients (mean age 56 ± 8 years) underwent CMR at baseline, 1 day (n = 17) and 11 ± 2 months after ablation (n = 38). LA phasic volumes, emptying fractions (LAEF), and longitudinal strain were measured using feature-tracking CMR. LA fibrosis was quantified using late gadolinium enhancement (LGE). Results: There were no acute changes in volume; however, active, total LAEF, and peak LA strain decreased significantly compared to the baseline. During long-term follow-up, there was a decrease in maximum but not minimum LA volume (from 99 ± 5.2 ml to 89 ± 4.7 ml; p =.009) and a decrease in total LAEF (from 43 ± 1.8% to 39 ± 2.0%; p =.001). In patients with AF recurrence, LA volumes were unchanged. However, total LAEF decreased from 38 ± 3% to 33 ± 3%; p =.015. Patients without AF recurrence had no changes in LA functional parameters during follow-up. The amount of LA LGE at long-term follow-up was higher compared to the baseline, however, was significantly less compared to immediately post-procedure (37 ± 1.9% vs. 47 ± 2.8%; p =.015). A higher increase in LA LGE extent compared to the baseline was associated with a greater decrease in total LAEF (r = −.59; p <.001). Conclusions: LA function is impaired acutely following AF catheter ablation. However, long-term changes of LA function are associated positively with the successful restoration of sinus rhythm and inversely with increased LA LGE.

Original languageEnglish (US)
JournalJournal of cardiovascular electrophysiology
DOIs
StateAccepted/In press - 2020

Keywords

  • atrial fibrillation
  • atrial function
  • cardiac MRI
  • catheter ablation
  • late gadolinium enhancement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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