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Impact of radiofrequency catheter ablation for atrial fibrillation in patients with left atrial enlargement

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Abstract

Little has been reported on the impact of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) in patients with left atrial enlargement (LAE). A total of 706 patients underwent an initial RFCA for AF between September 2014 and September 2019 in our hospital. These patients were categorized into two groups according to the pre-procedural left atrial diameter (LAD) measured by transthoracic echocardiography (TTE): LAE group with LAD ≥ 50 mm and non-LAE group with LAD < 50 mm. We compared the patient characteristics, ablation procedures, and late recurrence of AF (LRAF, defined as a recurrence of atrial tachyarrhythmia between 3 and 12 months after the RFCA) between the two groups. In addition, we performed follow-up TTE at 12 months after RFCA and investigated the factors associated with left atrium (LA) reverse remodeling in each group. LAE group and non-LAE group consisted of 155 and 551 patients, respectively. There were no significant differences in ablation procedures, procedure-related complications, and the incidence of LRAF between the two groups. Furthermore, non-PAF was identified as an independent predictor of LA reverse remodeling in LAE group by multiple regression analysis (P = 0.020). RFCA might be an effective and safe procedure even in patients with LAD ≥ 50 mm, using the contemporary 3D-guided mapping and ablation technologies. Moreover, RFCA can lead to LA reverse remodeling in 1 year if they have non-PAF before ablation.

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Acknowledgements

The authors thank Mr. John Martin for his linguistic assistance with this manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Osaka Rosai Hospital, 1179-3, Nagasone-cho, kita-ku, Sakai, Osaka, 591-8025, Japan

    Kohei Ukita, Yasuyuki Egami, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino & Jun Tanouchi

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  1. Kohei Ukita
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  2. Yasuyuki Egami
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  3. Akito Kawamura
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  4. Hitoshi Nakamura
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  5. Yutaka Matsuhiro
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  6. Koji Yasumoto
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  7. Masaki Tsuda
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  9. Yasuharu Matsunaga-Lee
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  10. Masamichi Yano
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Correspondence to Masami Nishino.

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Ukita, K., Egami, Y., Kawamura, A. et al. Impact of radiofrequency catheter ablation for atrial fibrillation in patients with left atrial enlargement. Heart Vessels 37, 1899–1905 (2022). https://doi.org/10.1007/s00380-022-02094-z

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  • DOI: https://doi.org/10.1007/s00380-022-02094-z

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