open access

Vol 27, No 2 (2020)
Original articles — Clinical cardiology
Published online: 2019-01-30
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Echocardiographic assessment in patients with atrial fibrillation (AF) and normal systolic left ventricular function before and after catheter ablation: If AF begets AF, does pulmonary vein isolation terminate the vicious circle?

Aleksandra Liżewska-Springer, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Tomasz Królak, Łukasz Drelich, Dariusz Kozłowski, Grzegorz Raczak
DOI: 10.5603/CJ.a2019.0004
·
Pubmed: 30701515
·
Cardiol J 2020;27(2):126-135.

open access

Vol 27, No 2 (2020)
Original articles — Clinical cardiology
Published online: 2019-01-30

Abstract

Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) can be curative. There are conflicting data on whether AF associated atrial and ventricular structural remodeling reverses after ablation. The aim of this study was to evaluate the hemodynamic effect of AF ablation in patients with preserved left ventricular ejection fraction (LVEF).

Methods: Forty three AF patients were studied (aged 56 ± 11 years; 29 male, 23% persistent AF, LVEF 50%) in whom RFCA was performed. Echocardiographic evaluation of atrial and ventricular diameters, volumes and strain imaging by two-dimensional speckle tracking were performed before and at least 6 months after RFCA. Nine patients had AF during baseline examination.

Results: A significant decrease in the left (LA) and right (RA) atrial volume and an increase in the LA strain were observed 15 ± 7 months after RFCA. In the subgroup with baseline sinus rhythm, the increment in LA strain was only borderline significant. An increase in RA, right ventricular (RV) and Biatrial strain was noticed (p < 0.05). LVEF and global longitudinal strain of the left ventricle (LV), however, did not improve substantially.

Conclusions: Radiofrequency catheter ablation of AF in patients with preserved LV systolic function results in significant improvement in RA and RV function with a substantial reduction in LA and RA size. No deleterious impact of AF ablation on LA function was revealed.

Abstract

Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) can be curative. There are conflicting data on whether AF associated atrial and ventricular structural remodeling reverses after ablation. The aim of this study was to evaluate the hemodynamic effect of AF ablation in patients with preserved left ventricular ejection fraction (LVEF).

Methods: Forty three AF patients were studied (aged 56 ± 11 years; 29 male, 23% persistent AF, LVEF 50%) in whom RFCA was performed. Echocardiographic evaluation of atrial and ventricular diameters, volumes and strain imaging by two-dimensional speckle tracking were performed before and at least 6 months after RFCA. Nine patients had AF during baseline examination.

Results: A significant decrease in the left (LA) and right (RA) atrial volume and an increase in the LA strain were observed 15 ± 7 months after RFCA. In the subgroup with baseline sinus rhythm, the increment in LA strain was only borderline significant. An increase in RA, right ventricular (RV) and Biatrial strain was noticed (p < 0.05). LVEF and global longitudinal strain of the left ventricle (LV), however, did not improve substantially.

Conclusions: Radiofrequency catheter ablation of AF in patients with preserved LV systolic function results in significant improvement in RA and RV function with a substantial reduction in LA and RA size. No deleterious impact of AF ablation on LA function was revealed.

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Keywords

atrial fibrillation, catheter ablation, pulmonary vein isolation, cardiac remodeling, echocardiography

About this article
Title

Echocardiographic assessment in patients with atrial fibrillation (AF) and normal systolic left ventricular function before and after catheter ablation: If AF begets AF, does pulmonary vein isolation terminate the vicious circle?

Journal

Cardiology Journal

Issue

Vol 27, No 2 (2020)

Pages

126-135

Published online

2019-01-30

DOI

10.5603/CJ.a2019.0004

Pubmed

30701515

Bibliographic record

Cardiol J 2020;27(2):126-135.

Keywords

atrial fibrillation
catheter ablation
pulmonary vein isolation
cardiac remodeling
echocardiography

Authors

Aleksandra Liżewska-Springer
Alicja Dąbrowska-Kugacka
Ewa Lewicka
Tomasz Królak
Łukasz Drelich
Dariusz Kozłowski
Grzegorz Raczak

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