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Temporal dynamics of left atrial reverse remodeling predicts atrial fibrillation ablation outcome: A 3-year longitudinal study
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Hui-Ling Lee1, Yi-Ting Hwang2, Chia-Hung Yang3, Po-Cheng Chang4, 5, Hung-Ta Wo4, Joseph Jasper Acosta4, 6, Ming-Shien Wen4, Chung-Chuan Chou4, 5, ✉
Journal of Geriatric Cardiology | 2026, 23(9) : 547 - 564
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Journal of Geriatric Cardiology | 2026, 23(9): 547-564
• RESEARCH ARTICLE •
Temporal dynamics of left atrial reverse remodeling predicts atrial fibrillation ablation outcome: A 3-year longitudinal study
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Hui-Ling Lee1, Yi-Ting Hwang2, Chia-Hung Yang3, Po-Cheng Chang4, 5, Hung-Ta Wo4, Joseph Jasper Acosta4, 6, Ming-Shien Wen4, Chung-Chuan Chou4, 5, ✉
Affiliations
  • 1.Department of Anesthesia, Chang Gung Memorial Hospital, Taipei branch, 10507 Taipei, Taiwan, China
  • 2.Department of Statistics, National Taipei University, 10438 Taipei, Taiwan, China
  • 3.Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, 23604 New Taipei, Taiwan, China
  • 4.Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branch, 33304 Taoyuan, Taiwan, China
  • 5.School of Medicine, Chang Gung University College of Medicine, 33302 Taoyuan, Taiwan, China
  • 6.Southern Philippine Medical Center, Davao City, 8000 Davao del Sur, Philippines
Published: 2026-09-28 doi: 10.26599/1671-5411.2026.09.001
Outline
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Background

Long-term dynamic changes in the left atrium (LA) following radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) remain unclear. We aimed to unveil the temporary dynamics of LA reverse remodeling and the optimal echocardiographic indicator and timing for evaluating RFCA outcomes in this 3-year longitudinal study.

Methods

Data were retrospectively collected from 400 consecutive patients undergoing RFCA for AF (paroxysmal 71%). Echocardiographic examinations were performed at 1 day, and 1, 3, 6, 12, 18, 24, 30, and 36 months after RFCA. Patients were classified into three groups based on RFCA outcomes. We constructed mean response curves to visualize the tendency between echocardiographic indicators and time across groups. Proportional odds models were built to determine the optimal echocardiographic indicator and follow-up time point for distinguishing the outcome group.

Results

After a mean follow-up duration of 81 ± 24 months, free of AF was achieved in 357 patients. Mean response curves of echocardiographic indicators differed between patients with and without AF recurrence. A flat slope of mean response curves in the first 3 months and deterioration of echocardiographic indices starting 18 months after RFCA indicated higher risks of AF recurrence. LA linear ablation didn't affect the longitudinal trend of echocardiographic indicators in paroxysmal AF, but retarded LA reverse remodeling process in persistent AF. LAEF at 36 months had the highest c-index for predicting AF recurrence during a median follow-up period of 80 months.

Conclusions

The longitudinal trend of echocardiographic indicators reflects long-term LA remodeling and can provide important information for individualized treatment strategies.

Hui-Ling Lee, Yi-Ting Hwang, Chia-Hung Yang, Po-Cheng Chang, Hung-Ta Wo, Joseph Jasper Acosta, Ming-Shien Wen, Chung-Chuan Chou. Temporal dynamics of left atrial reverse remodeling predicts atrial fibrillation ablation outcome: A 3-year longitudinal study. 老年心脏病杂志（英文）, 2026 , 23 (9) : 547 -564 . DOI: 10.26599/1671-5411.2026.09.001
Hui-Ling Lee, Yi-Ting Hwang, Chia-Hung Yang, Po-Cheng Chang, Hung-Ta Wo, Joseph Jasper Acosta, Ming-Shien Wen, Chung-Chuan Chou. Temporal dynamics of left atrial reverse remodeling predicts atrial fibrillation ablation outcome: A 3-year longitudinal study[J]. Journal of Geriatric Cardiology, 2026 , 23 (9) : 547 -564 . DOI: 10.26599/1671-5411.2026.09.001
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doi: 10.26599/1671-5411.2026.09.001
  • Online Date：2026-10-30
  • Published：2026-09-28
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Affiliations
    1.Department of Anesthesia, Chang Gung Memorial Hospital, Taipei branch, 10507 Taipei, Taiwan, China
    2.Department of Statistics, National Taipei University, 10438 Taipei, Taiwan, China
    3.Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, 23604 New Taipei, Taiwan, China
    4.Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branch, 33304 Taoyuan, Taiwan, China
    5.School of Medicine, Chang Gung University College of Medicine, 33302 Taoyuan, Taiwan, China
    6.Southern Philippine Medical Center, Davao City, 8000 Davao del Sur, Philippines

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表12种不同金属材料的力学参数
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多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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