AUTHOR=Angelini Eleonora , Sieweke Jan-Thorben , Berliner Dominik , Biber Saskia , Hohmann Stephan , Oldhafer Maximiliane , Schallhorn Sven , Duncker David , Veltmann Christian , Bauersachs Johann , Bavendiek Udo 

TITLE=Echocardiographic parameters indicating left atrial reverse remodeling after catheter ablation for atrial fibrillation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1270422

DOI=10.3389/fcvm.2023.1270422

ISSN=2297-055X

ABSTRACT=The echocardiographic parameters total atrial conduction time (PA-TDI duration), left atrial (LA) volume index (LAVI) and LA strain reflect adverse atrial remodeling and predict atrial fibrillation (AF).To investigate echocardiographic parameters indicating reverse LA-remodeling and potential associations with AF recurrence after pulmonary vein isolation (PVI).This prospective observational study consecutively enrolled patients scheduled for PVI for symptomatic AF. ECG and transthoracic echocardiography were performed the day before and after PVI as well as 3 months later. AF recurrence was determined by Holter ECG at 3 month and telephone follow-up at 12 months after PVI. Parameters of LA-remodeling (PA-TDI, LAVI and LA-strain-analysis: reservoir strain (LASr), conduit strain (LAScd), contraction strain (LASct)) were determined by transthoracic echocardiography.48 patients were included in the study (mean age: 61.4±12.2 years). PA-TDI significantly decreased the day after PVI compared to baseline (septal PA-TDI 103±13 vs. 82±14.9 ms, p≤0.001; lateral PA-TDI 122.4±14.8 vs 106.9±14.4 ms, p≤0.001) and at 3 month follow-up (septal PA-TDI: 77.8±14.5, p≤0.001; lateral PA-TDI 105.2±16.1, p≤0.001). LAVI showed a significant reduction at 3 months follow-up compared to baseline (47.7±14.4 vs. 40.5±9.7, p<0.05). LASr, LAScd, and LASct did not change after PVI compared to baseline. AF recurred in 10 patients after PVI (21%). Septal PA-TDI, septal a´, and LAVI/a´ determined the day after PVI, were associated with AF recurrence.Changes in echocardiographic parameters of LA-remodeling and -function indicate that functional electromechanical recovery preceded morphological reverse remodeling of the left atrium after PVI. Furthermore, these changes in echocardiographic parameters indicating LA reverse remodeling after PVI may identify patients at high risk for AF recurrence.