Why the study?
AF causes atrial remodeling, and the study aimed to evaluate the effect of RF pulmonary vein isolation on intra- and interatrial conduction times and remodeling.
Does pulmonary vein isolation with RF ablation improve intra- and interatrial conduction times in patients with paroxysmal atrial fibrillation?
Observational (n=50)
Does pulmonary vein isolation with RF ablation improve intra- and interatrial conduction times in patients with paroxysmal atrial fibrillation?
p-value: p=0.012 for interatrial conduction delay, 0.029 for intra-atrial conduction delay
Pulmonary vein isolation with RF ablation significantly decreases intra- and interatrial conduction times at 3 months in patients with paroxysmal atrial fibrillation, suggesting improvement in structural remodeling.
May suggest reverse remodeling after PVI in paroxysmal AF; hypothesis-generating and requires prospective validation before practice change.
Purpose:Atrial fibrillation(AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra- and interatrial conduction time, which is measured by tissue doppler echocardiography, indicates structural and electrical remodeling in the atrium. The aim of this study was to evaluate the effect of pulmonary vein isolation applied with RF ablation therapy on intra- and interatrial conduction time and to investigate the structural and electrically remodeling after treatment. Methods:Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 ± 11.731; mean left atrial diameter: 36.79 ± 4.318) who underwent CARTO® 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra- and the inter-atrial electromechanical delay was measured in all patients by tissue doppler echocardiography before and three months after RF ablation. Results:All intra- and interatrial conduction times were significantly decreased 3 months after RF ablation procedure(PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029). Conclusion:The results of our study suggest that providing stable sinus rhythm by the elimination of the AF triggering mechanisms with RF ablation of pulmonary vein isolation may slow down,stop or even improve structural remodeling at substrate level secondary to AF even in patients who did not yet develop atrial fibrosis and permanent structural changes.
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Dönmez et al. (2021) conducted an observational in Paroxysmal Atrial Fibrillation (n=50). Pulmonary vein isolation with RF ablation vs. Baseline was evaluated on Intra- and interatrial conduction time (p=0.012 for interatrial conduction delay, 0.029 for intra-atrial conduction delay).
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