{"id":"49f1d62cad52","type":"article","url":"https://hartvaat.nl/2026/01/29/lineaire-ablatie-van-de-voorwand-van-het-linkeratrium-vermindert-af-recidieven-b/","title":"Lineaire ablatie van de voorwand van het linkeratrium vermindert AF-recidieven bij aorta-inkapseling","title_en":"Left atrial anterior wall ablation reduces the recurrence of atrial fibrillation in patients with aortic encroachment","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003816?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003816?rss=1","authors":["Zhang","R.","Che","Q.-J.","Yao","P.-C.","Chen","M.","Wang","Q.-S.","Sun","J.","Li","W.","Zhang","P.-P.","Liu","B.","Li","Y.-G."],"significance":5,"published":"2026-01-29","source_date":"2026-01-29","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/mitraclip-transcatheter-mitralisreparatie/","https://hartvaat.nl/kennis/kleplijden/esc-richtlijn-kleplijden-2021/"],"congress":"","summary_en":"Mechanical compression from the ascending aorta on the left atrial anterior wall (LAAW) can cause low-voltage areas (LVAs) that raise the risk of recurrent atrial fibrillation (AF) after catheter ablation. This retrospective study (267 patients with both aortic encroachment and LAAW low-voltage areas, first ablation 2019-2023) examined different ablation strategies. Without LAAW ablation, patients with aortic encroachment had higher AF recurrence risk (aHR 2.29). Patients receiving LAAW ablation of complex fractionated electrograms (CFAE) had higher recurrence than those with linear LAAW ablation. Linear LAAW ablation was a strong independent predictor of fewer recurrences (HR 0.13). When LAAW low-voltage areas are present, linear ablation of the atrial anterior wall thus appears a highly effective strategy to reduce post-ablation AF recurrence.","created":"2026-07-03T10:32:27Z","updated":"2026-07-03T13:31:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Mechanische druk van de opstijgende aorta op de voorwand van het linkeratrium (LAAW) kan laagvoltagegebieden (LVA) veroorzaken, die het risico op recidief-atriumfibrilleren (AF) na katheterablatie verhogen. Deze retrospectieve studie (267 patiënten met zowel aorta-inkapseling als LAAW-laagvoltagegebieden, eerste ablatie 2019-2023) onderzocht verschillende ablatiestrategieën. Zonder LAAW-ablatie hadden patiënten met aorta-inkapseling een hoger AF-recidiefrisico (aHR 2,29). Patiënten die LAAW-ablatie van complexe gefractioneerde elektrogrammen (CFAE) kregen, hadden een hoger recidiefrisico dan patiënten met lineaire LAAW-ablatie. Lineaire LAAW-ablatie was een sterke onafhankelijke voorspeller van mínder recidieven (HR 0,13). Bij aanwezige LAAW-laagvoltagegebieden lijkt een lineaire ablatie van de atriale voorwand dus een zeer effectieve strategie om AF-recidief na ablatie te verminderen.","abstract_original":"<sec><st>Background</st>\n<p>Mechanical compression from the ascending aorta on the left atrial anterior wall (LAAW) can cause low voltage areas (LVAs), which are associated with a higher risk of atrial fibrillation (AF) recurrence after catheter ablation. This study investigates the AF recurrence rate post-LAAW complex fractionated atrial electrograms (CFAE) ablation or LAAW linear ablation in AF patients with aortic encroachment.</p>\n</sec>\n<sec><st>Methods</st>\n<p>We retrospectively analysed AF patients who underwent first-time ablation between 2019 and 2023 in our department and had preablation cardiac CT scans. The impact of LAAW-LVAs and different LAAW ablation strategies on AF recurrence within 1-year postprocedure was evaluated.</p>\n</sec>\n<sec><st>Results</st>\n<p>In total, 267 patients had both aortic encroachment and LAAW-LVAs. In the absence of LAAW ablation, patients with aortic encroachment had a significantly higher risk of AF recurrence compared with those without (adjusted HR (aHR): 2.29, 95% CI: 1.27 to 4.15, p=0.006). Patients receiving LAAW CFAE ablation had a higher recurrence rate than those receiving LAAW linear ablation (aHR: 3.29, 95% CI 1.42 to 7.63, p=0.006). Multivariable analysis identified that LAAW linear ablation was a strong independent predictor of reduced AF recurrence (HR: 0.13, 95% CI 0.06 to 0.28, p&lt;0.001).</p>\n</sec>\n<sec><st>Conclusions</st>\n<p>Aortic encroachment is a common and significant risk factor for AF recurrence after ablation. When LAAW-LVAs are present, performing LAAW linear ablation might be a highly effective strategy to reduce postablation AF recurrence.</p>\n</sec>"}