P5355Evaluation of functional recovery of structural reverse remodeling of the left atrium by pulmonary vein isolation in patients with atrial fibrillation

Background: Atrial fibrillation (AF) promotes left atrial (LA) remodeling and vice versa. Pulmonary vein isolation (PVI) effectively treats AF and affects LA structural reverse remodeling by maintaining sinus rhythm. However, the effects of PVI on LA functional reverse remodeling remain unclear. Purpose: This study aims to investigate structural and functional reverse remodeling of LA post initial PVI using serial echocardiographic studies and to assess the correlation between LA reverse remodeling and the long-term outcome of PVI. Methods: Of 245 consecutive patients undergoing initial PVI, we enrolled 112 patients (mean, 63±9 years; males, 65%; diagnosed with paroxysmal AF, 54%) based on the inclusion criteria of patients with no organic heart diseases, baseline LA volume index (LAVI) ≥34 mL/m2, and no AF recurrence for 1 year after PVI. We acquired the conventional and speckle tracking echocardiographic parameters within 24 hours and at 1 year after PVI. We defined the normal range of LAVI as LAVImax <34 mL/m2 according to the recent guidelines. LA functional parameters were also acquired from 10 healthy subjects (mean, 58±12 y; males, 70%) to assess whether the patients with AF obtained the normal LA function after PVI.