Atrial fibrillation ablation exerted stage-dependent improvements in left ventricular diastolic function, with patients having advanced LVDD (grades 2-3) demonstrating the greatest benefit.
Cohort (n=182)
Does catheter ablation for atrial fibrillation improve LV diastolic function and remodeling across different baseline stages of left ventricular diastolic dysfunction?
Atrial fibrillation ablation provides stage-dependent improvements in LV diastolic function and remodeling, with the greatest benefit observed in patients with advanced LVDD, suggesting advanced LVDD may be an expanded indication for ablation.
Atrial fibrillation (AF) coexists with left ventricular diastolic dysfunction (LVDD), but the impact of catheter ablation across LVDD stages is unclear. The study aimed to quantify to quantify AF ablation effects on LV diastolic function, remodeling, and rhythm outcomes across the LVDD spectrum. We studied 182 patients undergoing AF ablation, classified as no LVDD (Group A), grade 1 LVDD (Group B), or grades 2-3 LVDD (Group C). Echocardiography was performed at baseline and 1, 3, 6, and 12 months to assess diastolic indices and remodeling. Changes were evaluated with generalized estimating equations, and a 6-month landmark analysis related LVDD trajectories to AF recurrence. Group C showed sustained reductions in LVDD grade and E/e' with progressive left atrial reverse remodeling and early improvement in concentric remodeling. Group B demonstrated increased e' and E/A with later improvement in concentric remodeling but no consistent downgrading of LVDD. In Group A, LVDD grade rose then regressed by 12 months and remained below grade 1 AF recurrence did not differ among groups, but in Group C, sustained LVDD improvement was associated with lower recurrence after ablation. In conclusion, AF ablation exerts stage-dependent effects on LV diastolic function and remodeling; advanced LVDD confers the greatest benefit and may represent an expanded indication rather than a contraindication for ablation, and incorporating LVDD stage and its evolution into evaluation may refine prognosis and follow-up.
Cao et al. (Fri,) conducted a cohort in Atrial fibrillation and left ventricular diastolic dysfunction (n=182). Atrial fibrillation ablation vs. Different baseline LVDD grades (none, grade 1, grades 2-3) was evaluated on LV diastolic function, remodeling, and AF recurrence. Atrial fibrillation ablation exerted stage-dependent improvements in left ventricular diastolic function, with patients having advanced LVDD (grades 2-3) demonstrating the greatest benefit.