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Objective <p>This study aimed to explore the effects of the left atrial appendage closure (LAAC) procedure or LAAC combined with Radiofrequency Catheter Ablation (RFCA) on the cardiac structure and function in patients with atrial fibrillation (AF).</p> Methods <p>This retrospective cohort study included 130 patients with AF, of whom 83 underwent simple LAAC and 47 underwent LAAC combined with RFCA. Echocardiographic parameters, including left ventricular end-diastolic diameter (LVEDs), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and fractional shortening (FS), were assessed at baseline and at 3, 6, and 12 months postoperatively. Analyses were performed for the overall cohort and stratified by the presence of chronic heart failure (CHF).</p> Results <p>In the overall cohort, postoperative echocardiographic assessments demonstrated time-dependent changes in cardiac systolic function and structure. Changes in systolic function were predominantly observed during the early follow-up period (3–6 months), whereas structural parameters, particularly ventricular dimensions and volumes, exhibited more sustained changes throughout follow-up. When treatment strategies were compared, patients undergoing LAAC combined with RFCA showed more pronounced postoperative changes in indices of systolic function and ventricular volumes at multiple follow-up time points compared with those treated with simple LAAC. In subgroup analyses, remodeling trajectories differed according to heart failure status. Patients with CHF generally exhibited attenuated functional changes over time, whereas patients without CHF demonstrated more apparent early systolic functional changes, while structural parameters showed relatively consistent trends across subgroups.</p> Conclusion <p>In this retrospective cohort, LAAC combined with RFCA was associated with more favorable cardiac remodeling patterns than simple LAAC. These differences likely reflect rhythm restoration achieved through RFCA rather than a direct effect of LAAC itself.</p>

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Impact of left atrial appendage closure with or without radiofrequency ablation on cardiac remodeling in atrial fibrillation patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月10日

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  • Qi Zou,
  • Peng Chang,
  • Cheng Jiang,
  • Pengyang Lin,
  • Jiazheng Li,
  • Yangyang Yu,
  • Zhiliang Wei,
  • Shougang Sun

摘要

Objective

This study aimed to explore the effects of the left atrial appendage closure (LAAC) procedure or LAAC combined with Radiofrequency Catheter Ablation (RFCA) on the cardiac structure and function in patients with atrial fibrillation (AF).

Methods

This retrospective cohort study included 130 patients with AF, of whom 83 underwent simple LAAC and 47 underwent LAAC combined with RFCA. Echocardiographic parameters, including left ventricular end-diastolic diameter (LVEDs), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and fractional shortening (FS), were assessed at baseline and at 3, 6, and 12 months postoperatively. Analyses were performed for the overall cohort and stratified by the presence of chronic heart failure (CHF).

Results

In the overall cohort, postoperative echocardiographic assessments demonstrated time-dependent changes in cardiac systolic function and structure. Changes in systolic function were predominantly observed during the early follow-up period (3–6 months), whereas structural parameters, particularly ventricular dimensions and volumes, exhibited more sustained changes throughout follow-up. When treatment strategies were compared, patients undergoing LAAC combined with RFCA showed more pronounced postoperative changes in indices of systolic function and ventricular volumes at multiple follow-up time points compared with those treated with simple LAAC. In subgroup analyses, remodeling trajectories differed according to heart failure status. Patients with CHF generally exhibited attenuated functional changes over time, whereas patients without CHF demonstrated more apparent early systolic functional changes, while structural parameters showed relatively consistent trends across subgroups.

Conclusion

In this retrospective cohort, LAAC combined with RFCA was associated with more favorable cardiac remodeling patterns than simple LAAC. These differences likely reflect rhythm restoration achieved through RFCA rather than a direct effect of LAAC itself.