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Left Atrial Size and Function After Catheter Ablation of Atrial Fibrillation: Comparing Apples and Oranges

      We read with interest the meta-analysis of Jeevanantham et al
      • Jeevanantham V.
      • Ntim W.
      • Navaneethan S.D.
      • Shah S.
      • Johnson A.C.
      • Hall B.
      • Shah A.
      • Hundley W.G.
      • Daubert J.P.
      • Fitzgerald D.
      Meta-analysis of the effect of radiofrequency catheter ablation on left atrial size, volumes and function in patients with atrial fibrillation.
      titled “Meta-Analysis of the Effect of Radiofrequency Catheter Ablation on Left Atrial Size, Volumes and Function in Patients With Atrial Fibrillation,” published in the May 2010 issue of The American Journal of Cardiology. The relevance of the investigators' report is evident, because, as they correctly stated, the effects of catheter ablation on the left atrium are still unknown. After analyzing 17 reports concerning this subject, the investigators concluded that left atrial (LA) size decreases after ablation of atrial fibrillation (AF) and that LA function remains unaffected. When analyzed on the basis of AF recurrence, decrease in LA size was significant only in patients without AF recurrence. In addition, patients with AF recurrence showed a significant decrease in LA function.
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      Linked Article

      • Meta-Analysis of the Effect of Radiofrequency Catheter Ablation on Left Atrial Size, Volumes and Function in Patients With Atrial Fibrillation
        American Journal of CardiologyVol. 105Issue 9
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          The effects of radiofrequency catheter ablation (RFCA) on left atrial (LA) size, volumes, and function in patients with atrial fibrillation (AF) are not well understood. The aim of this study was to systematically review the effects of RFCA on LA size, volumes, and function in patients with AF. Medline, the Web of Science, the Cochrane Central Register of Controlled Trials, and the reference lists of retrieved reports were searched for relevant studies through April 2009. Studies conducted in patients with AF were included if their primary outcomes were changes in LA size or volumes and/or function before and after RFCA.
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      • Reply
        American Journal of CardiologyVol. 107Issue 1
        • Preview
          We read with interest comments of Drs. Hof and Loh. They appropriately point out the facts that we discussed in the limitations section of our meta-analysis, which include the different methods used in these studies to determine left atrial (LA) size and function. We agree with Drs. Hof and Loh that LA volume is a better representation of true LA size,1,2 which was the basis of our study aim: to systematically review the effects of radiofrequency catheter ablation (RFCA) on LA volumes and function in addition to LA size in patients with atrial fibrillation (AF).
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