AUTHOR=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. 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.830055

DOI=10.3389/fcvm.2022.830055

ISSN=2297-055X

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