Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling
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 proce...
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Sociedade Brasileira de Cardiologia (SBC)
2014-12-01
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doaj-00c38af2f9db401fa2a40500a3f139b82020-11-24T23:32:51ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702014-12-01103648549210.5935/abc.20140152S0066-782X2014002400007Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial RemodelingSimone Nascimento dos SantosBenhur Davi HenzAndré Rodrigues ZanattaJosé Roberto BarretoKelly Bianca LoureiroClarissa NovakoskiMarcus Vinícius Nascimento dos SantosFabio F. GiuseppinEdna Maria OliveiraLuiz Roberto LeiteBackground: 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/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001) compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400007&lng=en&tlng=enFibrilação AtrialRemodelamento AtrialAblação por CateterEcocardiografiaDébito CardíacoFunção Ventricular |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Simone Nascimento dos Santos Benhur Davi Henz André Rodrigues Zanatta José Roberto Barreto Kelly Bianca Loureiro Clarissa Novakoski Marcus Vinícius Nascimento dos Santos Fabio F. Giuseppin Edna Maria Oliveira Luiz Roberto Leite |
spellingShingle |
Simone Nascimento dos Santos Benhur Davi Henz André Rodrigues Zanatta José Roberto Barreto Kelly Bianca Loureiro Clarissa Novakoski Marcus Vinícius Nascimento dos Santos Fabio F. Giuseppin Edna Maria Oliveira Luiz Roberto Leite Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling Arquivos Brasileiros de Cardiologia Fibrilação Atrial Remodelamento Atrial Ablação por Cateter Ecocardiografia Débito Cardíaco Função Ventricular |
author_facet |
Simone Nascimento dos Santos Benhur Davi Henz André Rodrigues Zanatta José Roberto Barreto Kelly Bianca Loureiro Clarissa Novakoski Marcus Vinícius Nascimento dos Santos Fabio F. Giuseppin Edna Maria Oliveira Luiz Roberto Leite |
author_sort |
Simone Nascimento dos Santos |
title |
Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling |
title_short |
Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling |
title_full |
Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling |
title_fullStr |
Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling |
title_full_unstemmed |
Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling |
title_sort |
impact of atrial fibrillation ablation on left ventricular filling pressure and left atrial remodeling |
publisher |
Sociedade Brasileira de Cardiologia (SBC) |
series |
Arquivos Brasileiros de Cardiologia |
issn |
1678-4170 |
publishDate |
2014-12-01 |
description |
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/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001) compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, 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. |
topic |
Fibrilação Atrial Remodelamento Atrial Ablação por Cateter Ecocardiografia Débito Cardíaco Função Ventricular |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400007&lng=en&tlng=en |
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