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Background <p>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.</p> Methods <p>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.</p> Results <p>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; <i>P</i> &lt; .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]; <i>P</i> &lt; .001). These findings were consistent across all AF types.</p> Conclusions <p>The length of E- and A-wave adjacency appears to be a significant predictor of AR following AF ablation.</p> Graphical Abstract <p></p>

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

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • 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

摘要

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.

Graphical Abstract