Higher degree of left atrial structural remodeling in patients with atrial fibrillation and left ventricular systolic dysfunction. Akkaya, M., Higuchi, K., Koopmann, M., Damal, K., Burgon, N., Kholmovski, E., McGann, C., & Marrouche, N. j-JCE, 24(5):485--491, May, 2013.
bibtex   
@Article{RSM:Akk2013a,
  author =       "M. Akkaya and K. Higuchi and M. Koopmann and K. Damal and
                 N.S. Burgon and E. Kholmovski and C. McGann and N.
                 Marrouche",
  title =        "Higher degree of left atrial structural remodeling in
                 patients with atrial fibrillation and left ventricular
                 systolic dysfunction.",
  journal =      j-JCE,
  year =         "2013",
  month =        "May",
  volume =       "24",
  number =       "5",
  pages =        "485--491",
  robnote =      "BACKGROUND: Catheter ablation significantly improves the
                 left ventricular (LV) function in patients with atrial
                 fibrillation (AF) and LV systolic dysfunction. In this
                 study, we compared the degree of left atrial structural
                 remodeling (LA-SRM) in patients with normal versus reduced
                 LV ejection fraction (LVEF). We also studied the impact of
                 LA-SRM on LVEF improvement in patients undergoing ablation
                 of AF. METHOD AND RESULTS: We categorized 384 patients
                 into 2 groups based on their cardiac function: reduced
                 LVEF group (LVEF </=50\%; n = 105) and normal LVEF group
                 (LVEF > 50\%; n = 279). LVEF was determined prior and mean
                 8 +/- 3 months after catheter ablation for AF. Percentage
                 of LA-SRM was quantified using LGE-MRI and patients were
                 classified into 4 groups based on the amount of structural
                 remodeling in their LA wall: minimal </= 5\%, mild =
                 5-20\%, moderate = 20-35\%, and extensive >/= 35\%. The
                 average preablation LA-SRM (21.5 +/- 13.2\% vs 15.4 +/-
                 10.0\%; P < 0.001) was significantly higher in reduced
                 LVEF group than normal LVEF group. Among the 105 patients
                 with reduced LVEF, while there was a modest 11.7 +/- 8.4\%
                 average increase in LVEF following ablation, the greatest
                 increase was seen in patients with less extensive LA-SRM
                 (minimal = 19.3 +/- 5.1\%, n = 3, P = 0.02 and mild = 16.6
                 +/- 9.9\%, n = 48, P < 0.001). Patients with moderate and
                 extensive fibrosis had an average EF improvement of 8.7
                 +/- 11.1\% and 2.8 +/- 6.4\%, respectively (n = 39, P <
                 0.001 and n = 15, P = 0.11, respectively). CONCLUSION:
                 Patients with LV systolic dysfunction displayed a
                 comparatively greater LA-SRM than patients with normal
                 LVEF. Patients with lesser LA-SRM experienced a greater
                 improvement in LVEF after catheter ablation for AF.",
  bibdate =      "Sun May 25 06:14:09 2014",
}

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