Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) reduces left atrial (LA) volume post-ablation, a phenomenon termed reverse atrial remodeling, indicative of successful reversal of atrial cardiomyopathy progression. In contrast, pulse field ablation (PFA), a novel non-thermal technology, offers a promising efficacy and safety profile without inducing persistent atrial fibrosis. While RFCA-associated reverse atrial remodeling is well-documented, it remains uncertain whether PFA, operating on a non-thermal paradigm, also promotes this remodeling, which would enhance its physiological relevance in AF treatment. Additionally, RFCA studies show that LA wall thickness at the pulmonary vein (PV) antrum can predict PV reconnection and arrhythmia recurrence, but whether PFA affects LA thinning or enables similar predictions from post-treatment computed tomography (CT) scans is unknown. Moreover, epicardial adipose tissue (EAT), strongly linked to LA abnormalities and AF recurrence, can be quantified via CT, yet the impact of PFA on LA EAT remains unexplored. Finally, PFA's versatility, particularly in isolating the LA posterior wall (LAPW) in non-paroxysmal AF, raises questions about its effect on posterior wall thinning or EAT changes, factors associated with post-ablation recurrence
Study Type
OBSERVATIONAL
Enrollment
200
Hôpital Pitié Salpêtrière
Paris, Île-de-France Region, France
Difference between baseline and post-ablation LA indexed volume (ml/cm^2)
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation mean wall thickness, mm
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation Epicardial adipose tissue , mm^3
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation left atrial appendage indexed volume, ml/cm^2
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation left atrial appendage dimensions (long-axis, short-axis, ostium long-axis, ostium short-axis), mm
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation mean LA wall thickness at the LAPW, mm
Time frame: Post-procedural (3-months)
Difference between baseline and post-ablation epicardial adipose tissue at the PW, mm^3
Time frame: Post-procedural (3-months)
Recurrence of sustained atrial arrhythmia
Time frame: Post-procedural (3-months)
Recurrence of sustained atrial arrhythmia
Time frame: 12 months after procedure
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