Key result
Restoration of sinus rhythm in patients with persistent atrial fibrillation led to significant left ventricular remodelling at 12 months, including up to a 19.65% reduction in end-diastolic volume.
Why the study?
Atrial fibrillation is an urgent rhythm disturbance causing permanent disability, prompting an investigation into whether left ventricular remodelling is possible after restoring sinus rhythm.
Does restoration of sinus rhythm improve left ventricular remodelling in patients with persistent atrial fibrillation?
Observational (n=821)
Yes
Does restoration of sinus rhythm improve left ventricular remodelling in patients with persistent atrial fibrillation?
Restoration of sinus rhythm in patients with persistent atrial fibrillation is associated with significant left ventricular reverse remodelling and improvement in ejection fraction at 12 months.
May support rhythm restoration for LV remodelling in persistent AF; leaves open need for RCTs to confirm outcomes.
Atrial fibrillation is one of the most urgent rhythm disturbances leading to permanent disability of the population. Therefore, the aim of this study was to investigate the possibility of left ventricular remodelling after restoration of sinus rhythm. The results of treatment in 821 patients were analyzed, each of them was assigned to one of 4 groups depending on the tactics of surgical intervention: group 1 — electrical cardioversion was performed, group 2 — pacemaker implantation (DDD) and pharmacological cardioversion; 3rd group — electrical cardioversion and pacemaker implantation; and the 4th group — RFA was performed. After the treatment, a decrease in EDV was revealed by 18.7% in the 1st group, 13.7% in the 2nd group, 19.65% in the 3rd group and 11.3% in the 4th group. An increase in the SD was observed: by 14% in the 1st group, 5.6% in the 2nd group, 10.9% in the 3rd group and by 3.65% in the 4th group, as well as an increase in EF by 48% in the 1st group, 17.5% in group 2, 29.76% in group 3 and 4.5% in group 4. Thus, left ventricular remodelling is feasible after restoration of sinus rhythm after persistent atrial fibrillation.
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Romanenko et al. (2022) conducted an observational in Persistent atrial fibrillation (n=821). Restoration of sinus rhythm (electrical cardioversion, pacemaker, or radiofrequency ablation) plus amiodarone was evaluated on Echocardiographic indicators of heart chamber dimensions (end-diastolic volume and ejection fraction) (p=<0.05). Restoration of sinus rhythm in patients with persistent atrial fibrillation led to significant left ventricular remodelling at 12 months, including up to a 19.65% reduction in end-diastolic volume.
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