Arrhythmias & electrophysiology
Right atrial reverse remodeling after pulmonary vein isolation: Analyzing changes in volume and function using cardiac magnetic resonance imaging
Authors' conclusion
This study demonstrates that RF PVI results in reverse biatrial remodeling, with significant reductions observed in RA and LA volumes. RA function showed a significant improvement post-PVI, while LA function demonstrated persistent impairment at 3 months, possibly because of LA ablation scarring.
Study context
- Population
- Patients with AF undergoing first radiofrequency (RF) pulmonary vein isolation (PVI), without atrial flutter ablation74.4% male
- Participants
- 43 patients
- Exposure
- Before vs after RF PVI
- Outcome
- RA volumes and function by CMR
- Follow-up
- Early (<72 hours) and 3 months post-PVI
Main finding
As reported in the abstract
- Early post-PVI: Right atrial (RA) minimal volume index 28.7±10.3 → 26.0±9.9 mL/m²
- P=.03
- Early post-PVI: RA emptying fraction 37.3%±11.5% → 41.7%±10.1%
- P=.03
- 3 months: RA minimal volume index 28.7±10.3 → 24.8±8.8 mL/m²
- P=.002
- 3 months: RA maximal volume index 45.2±11.8 → 40.3±11.9 mL/m²
- P<.001
- 3 months: RA reservoir strain 16.2%±4.1% → 18.9%±3.6%
- P=.003
- 3 months: RA contractile strain 6.6%±2.6% → 8.3%±2.8%
- P=.005
Observational data: associations, not effects.
Further findings
Left atrial (LA) volumes · 3 months
- 3 months: LA maximal volume index 46.1±13.0 → 39.1±11.3 mL/m²
- P < 0.001
- LA volumes unchanged early post-PVI
LA function (strain) · 3 months
- 3 months: LA reservoir strain 18.6%±4.0% → 17.0%±3.4%
- P = 0.04
- 3 months: LA contractile strain 8.5%±3.0% → 6.9%±2.4%
- P < 0.01
- LA reservoir and contractile strain significantly diminished early post-PVI, persisting at 3 months
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Right atrial reverse remodeling after pulmonary vein isolation: Analyzing changes in volume and function using cardiac magnetic resonance imaging. Heart Rhythm. Published 23 March 2025. doi:10.
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