AUTHOR=Han Shaojie , Liu Ming , Jia Ruikun , Cen Zhifu , Guo Ran , Liu Guobin , Cui Kaijun 

TITLE=Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1009494

DOI=10.3389/fcvm.2022.1009494

ISSN=2297-055X

ABSTRACT=Abstract
Background: The results of studies evaluating the left atrial appendage (LAA) function and structure as predictors of atrial fibrillation (AF) recurrence after catheter ablation (CA) are contradictory. Therefore, we performed a meta-analysis to assess whether the LAA function and structure  can predict the recurrence of AF after CA.
Methods: The PubMed, EMBASE, Web of Science, and Cochrane library databases were used to conduct a comprehensive literature search. Finally, 37 studies encompassing 11 LAA parameters were included in this meta-analysis. 
Results: Compared with those in the nonrecurrence group, the recurrence group had increased LAA volume (SMD 0.53, 95% CI [0.36, 0.71] p<0.00001), LAA volume index, LAA orifice area, and LAA orifice short/long axis and decreased LAA emptying flow velocity (SMD -0.54, 95% CI [-0.68, -0.40], P<0.00001), LAA filling flow velocity, and LAA ejection fraction, while there was no significant difference in LAA morphology or LAA depth. 
Conclusions: Large LAA structure of pre-ablation (LAA volume, orifice area, orifice long/short axis, and volume index)  and decreased LAA function of pre-ablation (LAA emptying flow velocity, filling flow velocity, ejection fraction, and LASEC)  increase the odds of AF recurrence after CA.