Catheter Ablation -> SVT/AVNRT/WPW/AT: -> Mapping & Imaging D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-189 - Short And Long-term Associations Of Atrial Fibrillation Catheter Ablation With Left Atrial Structure And Function: A Cardiac Magnetic Resonance Study (ID 135)


Background: The effects of atrial fibrillation (AF) catheter ablation on Left atrium (LA) are poorly understood.
Objective: 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±5.2ml to 89±4.7ml, p=0.009) and a decrease in total LAEF (from 43±1.8% to 39±2.0%, p=0.001). In patients with AF recurrence, LA volumes were unchanged. However, total LAEF decreased from 38±3% to 33±3%; p=0.015. 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=0.015). A higher increase in LA LGE extent compared to the baseline was associated with a greater decrease in total LAEF (r=-0.59, p<0.001).
Conclusion: LA function is impaired acutely following AF catheter ablation. However, long-term changes of LA function are associated positively with successful restoration of sinus rhythm and inversely with increased LA LGE.