title: Significant improvement of left atrial and left atrial appendage function after catheter ablation for persistent atrial fibrillation.
abstract: BACKGROUND
  The long-term effects of catheter ablation (CA) on the left atrium and left atrial appendage (LAA) are unknown in persistent atrial fibrillation (AF). This study investigated left atrial (LA) reverse remodeling and evolution of LA/LAA function after successful CA for persistent AF and identified predictors for maintenance of sinus rhythm (SR) and LA reverse remodeling.
  
  
  RESULTS
  CA was performed in 123 patients with persistent AF. LA volumes, LA strain and LAA wall velocity were assessed both at baseline and at 12 months after ablation. Patients who maintained SR were divided into 2 groups according to whether LA volume decreased by ≥15% at follow-up (responders) or not (non-responders). During a follow-up period of 18±2 months, AF recurred in 45 patients (37%). Of the remaining 78 patients (63%) without recurrent AF, 62 patients (79%) were classified as responders. LA/LAA function significantly improved and the prevalence of spontaneous echo contrast decreased only in responders at follow-up. LA systolic strain and LAA wall velocity were independent predictors of both maintenance of SR (odds ratio [OR], 2.57; P=0.003; OR, 3.02; P=0.002, respectively) and LA reverse remodeling (OR, 4.44; P=0.007; OR, 3.52; P=0.01, respectively).
  
  
  CONCLUSIONS
  Successful CA is associated with LA reverse remodeling and LA/LAA functional recovery in patients with persistent AF. LA systolic strain and LAA wall velocity at baseline predicted both maintenance of SR and LA reverse remodeling.
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Machino-Ohtsuka
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Seo
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ishizu
authors.forename: Satomi
authors.initials: S
authors.lastname: Yanaka
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Akiko
authors.initials: A
authors.lastname: Atsumi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawamura
authors.forename: Yuki
authors.initials: Y
authors.lastname: Koshino
authors.forename: Takeshi
authors.initials: T
authors.lastname: Machino
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuroki
authors.forename: Hiro
authors.initials: H
authors.lastname: Yamasaki
authors.forename: Miyako
authors.initials: M
authors.lastname: Igarashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D016279:Atrial Function, Left; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged