Left atrial appendage morphofunctional indices could be predictive of arrhythmia recurrence post-atrial fibrillation ablation: a meta-analysis.
Arrhythmia recurrence
Atrial fibrillation
Catheter ablation
Left atrial appendage
Journal
The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
ISSN: 2090-911X
Titre abrégé: Egypt Heart J
Pays: Germany
ID NLM: 9106952
Informations de publication
Date de publication:
20 Apr 2023
20 Apr 2023
Historique:
received:
15
12
2022
accepted:
14
04
2023
medline:
20
4
2023
pubmed:
20
4
2023
entrez:
20
04
2023
Statut:
epublish
Résumé
Left atrium changes are implicated in atrial fibrillation (AF) substrate and are predictive of AF outcomes. Left atrial appendage (LAA) is an integral component of left atrial structure and could be affected by atrial cardiomyopathy. We aimed to elucidate the association between LAA indices and late arrhythmia recurrence after atrial fibrillation catheter ablation (AFCA). The MEDLINE database, ClinicalTrials.gov, medRxiv and Cochrane Library were searched for studies evaluating LAA and late arrhythmia recurrence in patients undergoing AFCA. Data were pooled by meta-analysis using a random-effects model. The primary endpoint was pre-ablation difference in LAA anatomic or functional indices. A total of 34 studies were found eligible and five LAA indices were analyzed. LAA ejection fraction and LAA emptying velocity were significantly lower in patients with AF recurrence post-ablation [SMD = - 0.66; 95% CI (- 1.01, - 0.32) and SMD = - 0.56; 95% CI (- 0.73, - 0.40) respectively] as compared to arrhythmia free controls. LAA volume and LAA orifice area were significantly higher in patients with AF recurrence post-ablation (SMD = 0.51; 95% CI 0.35-0.67, and SMD = 0.35; 95% CI 0.20-0.49, respectively) as compared to arrhythmia free controls. LAA morphology was not predictive of AF recurrence post-ablation (chicken wing morphology; OR 1.27; 95% CI 0.79-2.02). Moderate statistical heterogeneity and small case-control studies are the main limitations of our meta-analysis. Our findings suggest that LAA ejection fraction, LAA emptying velocity, LAA orifice area and LAA volume differ between patients suffering from arrhythmia recurrence post-ablation and arrhythmia free counterparts, while LAA morphology is not predictive of AF recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Left atrium changes are implicated in atrial fibrillation (AF) substrate and are predictive of AF outcomes. Left atrial appendage (LAA) is an integral component of left atrial structure and could be affected by atrial cardiomyopathy. We aimed to elucidate the association between LAA indices and late arrhythmia recurrence after atrial fibrillation catheter ablation (AFCA).
METHODS
METHODS
The MEDLINE database, ClinicalTrials.gov, medRxiv and Cochrane Library were searched for studies evaluating LAA and late arrhythmia recurrence in patients undergoing AFCA. Data were pooled by meta-analysis using a random-effects model. The primary endpoint was pre-ablation difference in LAA anatomic or functional indices.
RESULTS
RESULTS
A total of 34 studies were found eligible and five LAA indices were analyzed. LAA ejection fraction and LAA emptying velocity were significantly lower in patients with AF recurrence post-ablation [SMD = - 0.66; 95% CI (- 1.01, - 0.32) and SMD = - 0.56; 95% CI (- 0.73, - 0.40) respectively] as compared to arrhythmia free controls. LAA volume and LAA orifice area were significantly higher in patients with AF recurrence post-ablation (SMD = 0.51; 95% CI 0.35-0.67, and SMD = 0.35; 95% CI 0.20-0.49, respectively) as compared to arrhythmia free controls. LAA morphology was not predictive of AF recurrence post-ablation (chicken wing morphology; OR 1.27; 95% CI 0.79-2.02). Moderate statistical heterogeneity and small case-control studies are the main limitations of our meta-analysis.
CONCLUSIONS
CONCLUSIONS
Our findings suggest that LAA ejection fraction, LAA emptying velocity, LAA orifice area and LAA volume differ between patients suffering from arrhythmia recurrence post-ablation and arrhythmia free counterparts, while LAA morphology is not predictive of AF recurrence.
Identifiants
pubmed: 37079174
doi: 10.1186/s43044-023-00356-3
pii: 10.1186/s43044-023-00356-3
pmc: PMC10119349
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
29Informations de copyright
© 2023. The Author(s).
Références
Int J Cardiol. 2013 Sep 1;167(5):1984-9
pubmed: 22626840
Front Cardiovasc Med. 2021 Jan 22;7:605642
pubmed: 33553257
JACC Clin Electrophysiol. 2021 Mar;7(3):343-351
pubmed: 33516711
Pacing Clin Electrophysiol. 2018 Sep;41(9):1129-1135
pubmed: 30028029
J Interv Card Electrophysiol. 2021 Aug;61(2):293-302
pubmed: 32602004
Diagnostics (Basel). 2021 Aug 13;11(8):
pubmed: 34441399
J Cardiovasc Electrophysiol. 2019 Jul;30(7):1026-1035
pubmed: 30977168
Ann Intern Med. 2018 Dec 18;169(12):866-872
pubmed: 30508424
Circ J. 2013;77(7):1695-704
pubmed: 23535197
Am J Cardiol. 2011 May 15;107(10):1498-503
pubmed: 21414593
Int J Cardiol. 2020 Oct 1;316:272-278
pubmed: 32507394
J Am Coll Cardiol. 2017 Dec 26;70(25):3157-3172
pubmed: 29268928
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
Cardiol Res. 2017 Jun;8(3):96-104
pubmed: 28725325
Front Cardiovasc Med. 2022 Jan 28;9:822269
pubmed: 35155637
N Engl J Med. 2021 Jan 28;384(4):316-324
pubmed: 33197158
J Electrocardiol. 2020 Nov - Dec;63:139-144
pubmed: 33212414
Int J Cardiovasc Imaging. 2013 Apr;29(4):935-44
pubmed: 23197275
Circ J. 2022 Jan 25;86(2):299-308
pubmed: 34629373
BMC Med Res Methodol. 2014 Dec 19;14:135
pubmed: 25524443
Zhonghua Xin Xue Guan Bing Za Zhi. 2017 Nov 24;45(11):924-929
pubmed: 29166717
Internet Interv. 2022 Mar 02;28:100518
pubmed: 35257003
Echocardiography. 2018 Jul;35(7):985-990
pubmed: 29509964
J Atr Fibrillation. 2017 Feb 28;9(5):1526
pubmed: 29250273
J Cardiovasc Electrophysiol. 2016 May;27(5):542-8
pubmed: 26756553
Anatol J Cardiol. 2015 Sep 15;:
pubmed: 26680545
N Engl J Med. 2021 Jan 28;384(4):305-315
pubmed: 33197159
Europace. 2020 May 1;22(5):748-760
pubmed: 32227238
Sci Rep. 2020 May 15;10(1):8072
pubmed: 32415245
J Interv Card Electrophysiol. 2017 Aug;49(2):165-171
pubmed: 28567579
Circulation. 2019 Mar 5;139(10):e56-e528
pubmed: 30700139
Bioethics. 2023 Mar 25;:
pubmed: 36964989
Europace. 2015 Oct;17(10):1518-25
pubmed: 26498716
Fam Med Community Health. 2022 Nov;10(Suppl 1):
pubmed: 36450391
Circ Arrhythm Electrophysiol. 2022 Aug;15(8):e010850
pubmed: 35867397
Europace. 2017 Sep 01;19(9):1463-1469
pubmed: 27738076
Front Cardiovasc Med. 2021 Oct 14;8:719452
pubmed: 34722655
J Cardiovasc Comput Tomogr. 2019 Mar - Apr;13(2):105-112
pubmed: 30639114
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
Front Cardiovasc Med. 2021 Aug 12;8:677885
pubmed: 34458330
Am Heart J. 2019 Feb;208:110-119
pubmed: 30502925
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Echocardiography. 2015 Feb;32(2):272-80
pubmed: 24919546
Clin Cardiol. 2022 Mar;45(3):273-281
pubmed: 34799870
Front Physiol. 2021 May 26;12:674106
pubmed: 34122144
Echocardiography. 2015 Jul;32(7):1101-8
pubmed: 25362992
Int J Cardiovasc Imaging. 2021 Jun;37(6):2063-2070
pubmed: 33566262
Mediators Inflamm. 2020 Aug 21;2020:8360936
pubmed: 32904560
Europace. 2018 Jan 1;20(1):33-42
pubmed: 28444307
J Thorac Dis. 2021 Oct;13(10):5954-5963
pubmed: 34795943
Arch Cardiovasc Dis. 2013 Jan;106(1):36-43
pubmed: 23374970
J Am Coll Cardiol. 2020 Apr 7;75(13):1523-1534
pubmed: 32241367
Europace. 2018 Jan 1;20(1):e1-e160
pubmed: 29016840
Kardiol Pol. 2021;79(7-8):756-764
pubmed: 34002841
J Interv Card Electrophysiol. 2017 Apr;48(3):343-350
pubmed: 27943042
Clin Cardiol. 2021 Nov;44(11):1636-1645
pubmed: 34651337
Echocardiography. 2013 Aug;30(7):744-50
pubmed: 23461708
J Cardiovasc Electrophysiol. 2007 Jan;18(1):47-52
pubmed: 17096656
Front Cardiovasc Med. 2022 Feb 15;9:708298
pubmed: 35242821
BMC Med Res Methodol. 2014 Feb 21;14:30
pubmed: 24559167
Clin Cardiol. 2021 Mar;44(3):407-414
pubmed: 33559195
Open Heart. 2021 Jun;8(1):
pubmed: 34172560