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Journal of Echocardiography
Published in: Journal of Echocardiography 2/2019

01-06-2019 | Original Investigation

Improvement of left ventricular function after successful radiofrequency catheter ablation in persistent atrial fibrillation with preserved left ventricular ejection fraction: a comprehensive echocardiographic assessment using two-dimensional speckle tracking analysis

Authors: Tomoo Nagai, Junko Arakawa, Akira Hamabe, Hirotsugu Tabata

Published in: Journal of Echocardiography | Issue 2/2019

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Abstract

Background

A limited number of studies have investigated the effects of radiofrequency catheter ablation (RFCA) on left ventricular (LV) function and the left atrial (LA) size in patients with atrial fibrillation (AF). The purpose of this study was to conduct a comprehensive assessment of LV function in patients with AF with preserved left ventricular ejection fraction (LVEF) before and after RFCA.

Method

A total of 30 consecutive patients with no recurrences after RFCA for persistent AF (age, 57.7 ± 8.4 years) were enrolled. Transthoracic echocardiography was performed at the baseline and 6 months after the final RFCA using speckle tracking derived LV strain analysis.

Results

After RFCA, we measured decreases in the LA volume index (33.7 ± 10.4 ml/m2 vs. 24.6 ± 8.6 ml/m2, p < 0.0001), while we observed improvements in systolic indices such as LVEF (56.8 ± 9.8% vs. 65.1 ± 9.1%, p < 0.0001), global longitudinal strain (− 16.8 ± 4.4% vs. − 18.8 ± 3.4%, p = 0.0055) and twist (8.12 ± 3.66° vs. 12.33 ± 6.75°, p = 0.0050), and also in diastolic indices such as strain rate during early diastole (SRE) (0.73 ± 0.10 s−1 vs. 1.32 ± 0.29 s−1, p < 0.0001) and early transmitral inflow velocity (E)/SRE (1.11 ± 0.36 m vs. 0.61 ± 0.19 m, p < 0.0001). Logistic regression analysis showed that ΔE/SRE was a contributing factor for improvement in LVEF (odds ratio 126.9; p = 0.021).

Conclusion

In persistent AF with preserved LVEF, further improvement in LVEF and reverse remodeling of the LA are achieved after RFCA. LV filling pressure may play significant roles in the mechanisms.
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Metadata
Title
Improvement of left ventricular function after successful radiofrequency catheter ablation in persistent atrial fibrillation with preserved left ventricular ejection fraction: a comprehensive echocardiographic assessment using two-dimensional speckle tracking analysis
Authors
Tomoo Nagai
Junko Arakawa
Akira Hamabe
Hirotsugu Tabata
Publication date
01-06-2019
Publisher
Springer Japan
Published in
Journal of Echocardiography / Issue 2/2019
Print ISSN: 1349-0222
Electronic ISSN: 1880-344X
DOI
https://doi.org/10.1007/s12574-018-0399-z

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