Advanced echocardiography to improve outcomes after atrial fibrillation ablation

What is it about?

Atrial fibrillation is the most common heart rhythm disorder worldwide and is characterized by a rapid, irregular heart rhythm. Atrial fibrillation can lead to complications such as stroke or heart failure, reduced quality of life, cognitive dysfunction and death.​ This leads to a vicious circle. ​There are several treatments available for atrial fibrillation, including cryoballoon ablation. This is currently one of the safest and most effective treatments available. As "cryo" (freezing) suggests, this technique uses a coolant to freeze the tissue at the entrance to the pulmonary veins in the left atrium. This causes scarring, with the result that the electrical signals that cause atrial fibrillation are no longer transmitted. Despite technological improvements, one third of patients still suffer from atrial fibrillation after ablation, leading to more hospital admissions, new interventions, complications and even death. The left atrium plays an important role in the initiation and continuation of atrial fibrillation. Due to the chaotic, irregular heartbeats in the left atrium, this heart chamber undergoes a continuous adjustment process. The structure and function of the left atrium change and maintain the fibrillation: the function decreases and the size increases. Echocardiography plays a key role in the evaluation of the left atrium. The paper aims to assess the role of left atrial function to predict the recurrence of atrial fibrillation after cryoballoon ablation. Left atrial function can be evaluated using 'speckle tracking imaging', which is a technique that assesses the deformation of the heart muscle by following the speckles that are formed naturally when the ultrasound interacts with the heart tissue. The study showed that left atrial function assessed by speckle tracking echocardiography helps predict the recurrence of atrial fibrillation after ablation. Moreover, a. large number of the patients included in the study had impaired left atrial function but normal left atrial dimension

Featured Image

Photo by Jair Lázaro on Unsplash

Photo by Jair Lázaro on Unsplash

Why is it important?

Our paper shows that ore subtle forms of left atrial disease may be present even before left atrial enlargement in patients with atrial fibrillation. Therefore, a thorough screening before the intervention may be important to better select patients who will benefit from the ablation and to improve their outcome.

Perspectives