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Overview
 
 
Andrea Maria Paparella, Andrea Maria Paparella, Luigi Pannone, Luigi Pannone, Gianni Pedrizzetti, Gianni Pedrizzetti, Giacomo Talevi, Giacomo Talevi, Domenico Giovanni Della Rocca, Domenico Giovanni Della Rocca, Antonio Sorgente, Antonio Sorgente, Rani Kronenberger, Rani Kronenberger, Gaetano Paparella, Gaetano Paparella, Ingrid Overeinder, Ingrid Overeinder, Gezim Bala, Gezim Bala, Alexandre Almorad, Alexandre Almorad, Erwin Ströker, Erwin Ströker, Juan Antonio Sieira Rodriguez-Moret, Juan Antonio Sieira Rodriguez-Moret, Mark La Meir, Mark La Meir, Andrea Sarkozy, Andrea Sarkozy, Pedro Brugada, Pedro Brugada, Gian Battista Chierchia, Gian Battista Chierchia, Ali Gharaviri, Ali Gharaviri, Carlo de Asmundis, Carlo de Asmundis
 

Contribution to journal

Abstract 

Background and aims: Hybrid atrial fibrillation (AF) ablation is a therapeutic option in non-paroxysmal AF. Our study examines cardiac mechanics changes after hybrid AF ablation plus epicardial closure of left atrial appendage (LAA). Methods: All consecutive patients undergoing hybrid AF ablation at UZ Brussel were evaluated. They received pulmonary vein isolation (PVI), posterior wall isolation (LAPWI), and epicardial LAA closure. Left atrium (LA) and Left ventricle (LV) mechanics were analyzed, with the following measures obtained at baseline, post-ablation, and follow-up: 1) volumes (EDV, ESV); 2) ejection fraction (EF); 3) strain (ENDO GCS, ENDO GLS); 4) forces (LVLF, LVsysLF, LVim, LVs). Results: A total of 50 patients were included. At follow-up, LAEDV decreased from baseline [44.7 mL vs 53.8 mL, P = 0.025]. LA ENDO GCS and GLS increased post-ablation, with further GLS improvement at follow-up. LV ENDO GCS and LV ENDO GLS also rose post-ablation [-26.7\% vs. −22.5\%, P < 0.001] and [-20.57\% vs. −16.6\%, P < 0.001], respectively. LVEF increased post-ablation [54.6\% vs 46.3\%, P < 0.001]. There was an increase in all LV hemodynamic forces (HDFs) and in particular: LVLF and LVsysLF increased post-ablation [15.5\% vs 10.4\%, P < 0.001] and [21.5\% vs 14.11\%, P < 0.001], respectively. LVim also increased post-ablation [19.6\% vs 12.8\%, P < 0.001]. Finally, there was an increase in LVs post-ablation compared to baseline [10.6\% vs 5.4\%, P < 0.001]. Conclusion: In patients undergoing hybrid AF ablation, there was a significant and persistent improvement in the mechanical and hemodynamic functions of both LA and LV.

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