Key result
Radiofrequency catheter ablation significantly worsened left ventricular diastolic function parameters, including a decrease in the heart rate-adjusted E/A ratio (P=0.009) up to 1 month post-ablation.
Why the study?
Does radiofrequency catheter ablation impair left ventricular systolic or diastolic function in patients with preserved baseline ejection fraction?
Observational (n=40)
Does radiofrequency catheter ablation impair left ventricular systolic or diastolic function in patients with preserved baseline ejection fraction?
p-value: p=0.009
Radiofrequency catheter ablation for tachycardias does not impair left ventricular systolic function but causes transient, significant deterioration in diastolic function parameters, likely due to localized myocardial thermal injury.
May transiently worsen diastolic function post-ablation in preserved EF; leaves open prospective validation of clinical impact.
Radiofrequency (RF) catheter ablation has become standard therapy for many types of arrhythmias. RF energy may cause deterioration in left ventricular function by damaging the myocardium. The aim of the present study was to assess the changes in left ventricular function after catheter ablation using various echocardiographic parameters. Forty patients (22 women), aged 37 +/- 14 years (range, 15-76 years), underwent catheter ablation for various tachycardias. Routine echocardiogaphic examination was done in all patients. Left ventricular systolic function was evaluated by the modified Simpson method and tissue Doppler. With regard to left ventricular diastolic function parameters, diastolic early (E) and late (A) transmitral filling velocities, deceleration time (DT), isovolumetric relaxation time (IVRT), and tissue Doppler parameters were assessed. All ventricular function parameters were assessed before, and 1 hour, 1 day, and 1 month after the catheter ablation procedure. To avoid any influence of heart rate on diastolic function parameters, the E/A ratio, DT, and IVRT were adjusted to heart rate (cE/A, cDT, cIVRT). No changes in left ventricular systolic function after the ablation were observed. After the ablation procedure (1 hour, 1 day, and 1 month) the cE/A ratio decreased from 1.42 +/- 0.43 to 1.19 +/- 0.40, 1.18 +/- 0.40, and 1.30 +/- 0.33 (P = 0.009), respectively. cDT increased from 210 +/- 54 to 272 +/- 64, 255 +/- 60, 240 +/- 64 (P = 0.001), respectively. Likewise cIVRT increased from 113 +/- 22 to 133 +/- 54, 123 +/- 27, 117 +/- 19 (P = 0.007), respectively. Significant changes were also observed concerning tissue Doppler parameters in assessing diastolic function. Although no significant changes were observed in systolic function after RF ablation, this procedure may have some detrimental effects on ventricular diastolic function para-meters.
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Eksik et al. (2004) conducted an observational in Various tachycardias (n=40). Radiofrequency catheter ablation vs. Baseline (pre-ablation) was evaluated on Changes in left ventricular systolic and diastolic function parameters (p=0.009). Radiofrequency catheter ablation significantly worsened left ventricular diastolic function parameters, including a decrease in the heart rate-adjusted E/A ratio (P=0.009) up to 1 month post-ablation.
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