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

• Published in: Frontiers in cardiovascular medicine Vol. 9; p. 830055
• Main Authors: Karanasos, Antonios, Tyrovolas, Konstantinos, Tsiachris, Dimitrios, Efremidis, Michalis, Kordalis, Athanasios, Karmpalioti, Maria, Prappa, Efstathia, Karagiannis, Stefanos, Aggeli, Constantina, Gatzoulis, Konstantinos, Tousoulis, Dimitrios, Tsioufis, Costas, Toutouzas, Konstantinos P
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 09.03.2022
• Subjects: atrial fibrillation; Cardiovascular Medicine; catheter ablation—atrial fibrillation; left atrium; real-time three-dimensional echocardiography; volume pressure loops; atrial fibrillation; real-time three-dimensional echocardiography; left atrium; catheter ablation—atrial fibrillation; volume pressure loops
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2022.830055

Left 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. To investigate changes in LA function by volume-pressure loops after paroxysmal AF ablation and explored potential differences between the radiofrequency and cryoballoon ablation. We 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. Average LA pressure, A-wave amplitude, and V-wave amplitude were increased post-procedurally ( < 0.001). Overall, A-loop area decreased ( = 0.001) and V-loop area tended to increase ( = 0.07). The change in both A-loop and V-loop areas was similar between radiofrequency- and cryoballoon-treated patients ( = 0.18 and = 0.52, respectively). However, compared with cryoballoon-treated patients, radiofrequency-treated patients had higher increase in the stiffness constant ( = 0.059; 95% CI: 0.022-0.096; = 0.006). AF 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.