Abstract 1583: Improvement of Left Ventricular Deformation after Catheter Ablation for Isolated Paroxysmal Atrial Fibrillation in Patients with Normal Ejection Fraction: a 2D Strain Study
Background: Paroxysmal isolated atrial fibrillation (AF) is generally associated with normal left ventricular (LV) ejection fraction. Recently, echocardiographs have been implemented by 2-dimensional (2D) strain technique, a new tool based on speckle tracking which allows accurate evaluation of the three components of LV deformation (circumferential, radial and longitudinal strains).
Objective: The aim of this prospective study was
to evaluate whether 2D strain evaluation could point out alteration of LV deformation in patients with paroxysmal AF and normal ejection fraction in comparison with controls;
to evaluate the evolution of the different strain components after AF catheter ablation.
Methods: Patients with isolated paroxysmal AF were investigated with a VIVID7 (General Electric) before ablation, at 1 month (M+1) and at 6 month (M+6) after catheter ablation. Statistical analysis was performed with a paired Student t-test.
Results: Thirty consecutive patients (mean 56.8 ± 12.7 years, 6 women) with isolated paroxysmal AF (since mean 9.3 years) and 30 controls were investigated. Before ablation, no significant difference was observed in term of LV ejection fraction between the 2 groups (p ns). In patients with paroxysmal AF, global longitudinal strain (GLS) and global circumferential strain (GCS) were significantly reduced compared to controls: GLS was −17.7 ± 2.4% vs −21.8 ± 2.2% in controls (p<0.001) and GCS was -16.0 ± 2.9% vs -20.8 ± 3.4% in controls (p<0.001). In contrast, no significant difference was observed for the global radial strain (GRS). After ablation, GLS increased from 17.7±2.4% to −20.5±2.0% (M+1)(p<0.001), and to −20.9±2.6%(M+6)(p<0.001), and GCS increased from −16.0±2.9% to −17.6±2.6% (M+1)(p <0.001), and −17.2±1.3% (M+6)(p<0.05). GRS was not significantly modified (from 41.5±17.5% to 38.2±12.9% (M+1)(p ns) and 40.7±12.4% (M+6)(p ns)).
Conclusions: Paroxysmal AF induced subclinical LV dysfunction as demonstrated by the decrease in longitudinal and circumferential strains in patients with normal ejection fraction. In our patients, these parameters of LV dysfunction were improved after AF catheter ablation.