Successful radiofrequency ablation for atrial fibrillation significantly reduced left ventricular filling pressure (E/e' ratio 11.5 to 7.1, p<0.001) and left atrial volume index.
Observational (n=141)
Does successful radiofrequency ablation improve left ventricular filling pressure and left atrial remodeling in patients with drug-refractory atrial fibrillation?
Successful restoration of sinus rhythm via AF ablation is associated with significant reverse left atrial remodeling and improved left ventricular filling pressures.
Absolute Event Rate: 7.1% vs 12%
p-value: p=<0.001
BACKGROUND: Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. OBJECTIVE: To evaluate the impact of AF ablation on estimated LV filling pressure. METHODS: A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. RESULTS: One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m(2) ± 10.6 mL/m(2) to 22.6 mL/m(2) ± 1.1 mL/m(2), p < 0.001) compared to the non-successful group (37.7 mL/m(2) ± 14.3 mL/m(2) to 37.5 mL/m(2) ± 14.5 mL/m(2), p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). CONCLUSION: Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.
Santos et al. (Wed,) conducted a observational in Drug-refractory atrial fibrillation (n=141). Radiofrequency ablation vs. Non-successful ablation (recurrent AF) was evaluated on Left ventricular filling pressure (E/e' ratio) (p=<0.001). Successful radiofrequency ablation for atrial fibrillation significantly reduced left ventricular filling pressure (E/e' ratio 11.5 to 7.1, p<0.001) and left atrial volume index.