Left Atrial Function Post Radiofrequency and Cryoballoon Ablation Assessed by Volume-Pressure Loops

被引:4
作者
Karanasos, Antonios [1 ]
Tyrovolas, Konstantinos [2 ]
Tsiachris, Dimitrios [3 ]
Efremidis, Michalis [2 ]
Kordalis, Athanasios [1 ,3 ]
Karmpalioti, Maria [1 ]
Prappa, Efstathia [2 ]
Karagiannis, Stefanos [3 ]
Aggeli, Constantina [1 ]
Gatzoulis, Konstantinos [1 ]
Tousoulis, Dimitrios [1 ]
Tsioufis, Costas [1 ]
Toutouzas, Konstantinos P. [1 ]
机构
[1] Hippokrateion Hosp, Athens Med Sch, Dept Cardiol 1, Athens, Greece
[2] Evangelismos Gen Hosp Athens, Dept Cardiol 2, Athens, Greece
[3] Athens Med Ctr, Athens Heart Ctr, Athens, Greece
关键词
catheter ablation-atrial fibrillation; atrial fibrillation; left atrium; real-time three-dimensional echocardiography; volume pressure loops; PULMONARY VEIN ISOLATION; CATHETER ABLATION; FIBRILLATION;
D O I
10.3389/fcvm.2022.830055
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundLeft atrial (LA) function is linked to atrial fibrillation (AF) pathogenesis. AF catheter ablation decreases disease burden with potentially favorable effects on cardiac function. Atrial volume-pressure loops can optimally assess the LA function. ObjectiveTo investigate changes in LA function by volume-pressure loops after paroxysmal AF ablation and explored potential differences between the radiofrequency and cryoballoon ablation. MethodsWe analyzed 44 patients undergoing paroxysmal AF ablation from 2 centers, 22 treated with radiofrequency and 22 with cryoablation. Pre- and post-procedure, all patients underwent a real-time three-dimensional transthoracic ECG to evaluate LA volume, while simultaneously recording LA pressure following transseptal puncture. Volume-pressure loops pre- and post-procedure were created by paired data. Areas of A-loop (LA booster pump function) and V-loop (LA reservoir function), and the stiffness constant determining the slope of the exponential curve during LA filling were calculated. ResultsAverage LA pressure, A-wave amplitude, and V-wave amplitude were increased post-procedurally (p < 0.001). Overall, A-loop area decreased (p = 0.001) and V-loop area tended to increase (p = 0.07). The change in both A-loop and V-loop areas was similar between radiofrequency- and cryoballoon-treated patients (p = 0.18 and p = 0.52, respectively). However, compared with cryoballoon-treated patients, radiofrequency-treated patients had higher increase in the stiffness constant (b = 0.059; 95% CI: 0.022-0.096; p = 0.006). ConclusionAF catheter ablation by the radiofrequency or cryoballoon is associated with the decrease of the booster pump function and increase of the reservoir function. Moreover, there is a post-procedural increase of LA pressure which is associated with an acute increase in LA stiffness in radiofrequency ablation, but not in cryoablation.
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