Prognostic impact of E- and A-wave adjacency after atrial fibrillation ablation.

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2025-07-30 DOI:10.1007/s00392-025-02714-4

Jumpei Saito, Kato Daiki, Sato Hirotoshi, Toshihiko Matsuda, Yui Koyanagi, Katsuya Yoshihiro, Yuma Gibo, Ishigaki Shigehiro, Soichiro Usumoto, Taro Kimura, Suguru Shimazu, Wataru Igawa, Seitaro Ebara, Toshitaka Okabe, Naoei Isomura, Masahiko Ochiai

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引用次数: 0

Abstract

Background: In adult patients with systolic heart failure, the presence of adjacent, nonoverlapping E and A waves on Doppler echocardiography is associated with optimal cardiac output and favorable clinical outcomes. However, the clinical significance of echocardiographic adjacency in patients with atrial fibrillation (AF) remains uncertain. We aimed to explore the relationship between E- and A-wave adjacency assessed the day after catheter ablation and the recurrence of atrial arrhythmias (AR) following AF ablation.

Methods: This study included patients with AF who underwent first-time arrhythmia ablation. Transthoracic echocardiography was performed on the day following catheter ablation to evaluate the presence of E- and A-wave adjacency. The relationship between overlap length and recurrence of AR after AF ablation was analyzed.

Results: The study included 175 patients (124 males; mean age: 68 [range 52-79] years; mean CHA2DS2-Vasc score: 2 [range 0-4]; and 93 with paroxysmal AF) who underwent AF ablation. There were no significant differences between the two groups in terms of heart failure history or echocardiographic parameters prior to catheter ablation. However, the absolute overlap length was significantly prolonged in the AR group (59 [range 9-160] msec vs. 120 [range 28.6-226] msec; P < .001). Furthermore, the AR rate was significantly lower in the group without prolonged overlap length (hazard ratio, 0.15 [95% confidence interval, 0.07-0.30]; P < .001). These findings were consistent across all AF types.

Conclusions: The length of E- and A-wave adjacency appears to be a significant predictor of AR following AF ablation.

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心房颤动消融后E波和a波邻接对预后的影响。

背景：在收缩期心力衰竭的成年患者中，多普勒超声心动图上出现邻近的、不重叠的E和A波与最佳心输出量和良好的临床结果相关。然而，超声心动图邻接在心房颤动（AF）患者中的临床意义仍不确定。我们的目的是探讨导管消融后一天评估的E波和a波邻接性与房颤消融后房性心律失常（AR）复发的关系。方法：本研究纳入首次行心律失常消融术的房颤患者。在导管消融后的第二天进行经胸超声心动图以评估E波和a波邻近的存在。分析重叠长度与房颤消融后AR复发的关系。结果：纳入175例患者，其中男性124例；平均年龄：68岁[52-79]岁；平均CHA2DS2-Vasc评分：2[范围0-4]；阵发性房颤患者93例接受房颤消融治疗。两组患者在导管消融前心衰史或超声心动图参数方面无显著差异。然而，AR组的绝对重叠长度明显延长(59[范围9-160]msec vs. 120[范围28.6-226]msec；结论：E波和a波相邻长度似乎是AF消融后AR的重要预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.