Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation
ABSTRACT Background A left atrial (LA) posterior wall isolation (PWI) is a common additional strategy for persistent atrial fibrillation (PeAF) ablation; yet its impact on the LA function remains unclear. Objective This study aimed to evaluate the effect of the PWI on the LA contractile function usi...
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Wiley
2025-08-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.70179 |
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| author | Kazuki Noda Shinichiro Sunamura Masahiro Suzuki Kazuyuki Shibutani Atsushi Tanita Tsuyoshi Ogata Toru Takii Ryoichi Ushigome Yuji Wakayama Koji Kumagai Shigeto Namiuchi |
| author_facet | Kazuki Noda Shinichiro Sunamura Masahiro Suzuki Kazuyuki Shibutani Atsushi Tanita Tsuyoshi Ogata Toru Takii Ryoichi Ushigome Yuji Wakayama Koji Kumagai Shigeto Namiuchi |
| author_sort | Kazuki Noda |
| collection | DOAJ |
| description | ABSTRACT Background A left atrial (LA) posterior wall isolation (PWI) is a common additional strategy for persistent atrial fibrillation (PeAF) ablation; yet its impact on the LA function remains unclear. Objective This study aimed to evaluate the effect of the PWI on the LA contractile function using intracardiac echocardiography (ICE). Methods Patients who underwent catheter ablation of PeAF were categorized into extensive encircling pulmonary vein isolation (EEPVI) and PWI groups. The LA contractile function was assessed using the PV reversal wave (PVa) velocity measured by ICE. Results No significant difference in the PVa velocity was observed between the EEPVI and PWI group. The EEPVI group patients were categorized into four groups based on scar extent: low‐scar, anterior wall (AW)‐scar‐only, posterior wall (PW)‐scar‐only, and both walls‐scarred. Compared to the low‐scar group, the both walls‐scar group had significantly lower PVa velocities; though no significant difference was found compared to the PW‐scar‐only group. The PVa velocity had a significant correlation with the AW scar. Furthermore, all patients enrolled in this study were also categorized into four groups based on the scar presence, similar to the previous study. Compared with the low‐scar group, the PVa velocities were significantly lower in the AW‐scar‐only and both walls‐scar groups; however, there was no significant difference in the PW‐scar‐only group. The PVa velocity was significantly correlated with the AW scar. Conclusion An LA PWI did not significantly impair the LA contractile function. AW scarring appeared to have a greater impact on the LA contractility than the PWI or scarring. |
| format | Article |
| id | doaj-art-fba1a8b7d5e94f30828f9579c04a1dd2 |
| institution | Kabale University |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
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| series | Journal of Arrhythmia |
| spelling | doaj-art-fba1a8b7d5e94f30828f9579c04a1dd22025-08-26T10:38:54ZengWileyJournal of Arrhythmia1880-42761883-21482025-08-01414n/an/a10.1002/joa3.70179Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation AblationKazuki Noda0Shinichiro Sunamura1Masahiro Suzuki2Kazuyuki Shibutani3Atsushi Tanita4Tsuyoshi Ogata5Toru Takii6Ryoichi Ushigome7Yuji Wakayama8Koji Kumagai9Shigeto Namiuchi10Department of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanUshigome Clinic Sendai JapanWakayama Clinic Sendai JapanDepartment of Cardiovascular Medicine Tohoku Medical and Pharmaceutical University Sendai JapanDepartment of Cardiology Sendai City Medical Center Sendai Open Hospital Sendai JapanABSTRACT Background A left atrial (LA) posterior wall isolation (PWI) is a common additional strategy for persistent atrial fibrillation (PeAF) ablation; yet its impact on the LA function remains unclear. Objective This study aimed to evaluate the effect of the PWI on the LA contractile function using intracardiac echocardiography (ICE). Methods Patients who underwent catheter ablation of PeAF were categorized into extensive encircling pulmonary vein isolation (EEPVI) and PWI groups. The LA contractile function was assessed using the PV reversal wave (PVa) velocity measured by ICE. Results No significant difference in the PVa velocity was observed between the EEPVI and PWI group. The EEPVI group patients were categorized into four groups based on scar extent: low‐scar, anterior wall (AW)‐scar‐only, posterior wall (PW)‐scar‐only, and both walls‐scarred. Compared to the low‐scar group, the both walls‐scar group had significantly lower PVa velocities; though no significant difference was found compared to the PW‐scar‐only group. The PVa velocity had a significant correlation with the AW scar. Furthermore, all patients enrolled in this study were also categorized into four groups based on the scar presence, similar to the previous study. Compared with the low‐scar group, the PVa velocities were significantly lower in the AW‐scar‐only and both walls‐scar groups; however, there was no significant difference in the PW‐scar‐only group. The PVa velocity was significantly correlated with the AW scar. Conclusion An LA PWI did not significantly impair the LA contractile function. AW scarring appeared to have a greater impact on the LA contractility than the PWI or scarring.https://doi.org/10.1002/joa3.70179catheter ablationintracardiac echocardiographyleft atrial contractile functionposterior wall isolation atrial fibrillation |
| spellingShingle | Kazuki Noda Shinichiro Sunamura Masahiro Suzuki Kazuyuki Shibutani Atsushi Tanita Tsuyoshi Ogata Toru Takii Ryoichi Ushigome Yuji Wakayama Koji Kumagai Shigeto Namiuchi Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation Journal of Arrhythmia catheter ablation intracardiac echocardiography left atrial contractile function posterior wall isolation atrial fibrillation |
| title | Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation |
| title_full | Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation |
| title_fullStr | Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation |
| title_full_unstemmed | Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation |
| title_short | Impact of Left Atrial Ablation on the Atrial Contractile Function: Insights From Intracardiac Echocardiography and Electroanatomical Mapping in Persistent Atrial Fibrillation Ablation |
| title_sort | impact of left atrial ablation on the atrial contractile function insights from intracardiac echocardiography and electroanatomical mapping in persistent atrial fibrillation ablation |
| topic | catheter ablation intracardiac echocardiography left atrial contractile function posterior wall isolation atrial fibrillation |
| url | https://doi.org/10.1002/joa3.70179 |
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