Abstract 719: Early Cardiac Reverse Remodeling after Catheter Ablation for Atrial Fibrillation
Atrial fibrillation (AF) and left ventricular systolic dysfunction often coexist. AF-induced ventricular remodeling may be underestimated, even in patients with paroxysmal AF. To determine in witch extent, pulmonary vein isolation is efficient to improve left ventricle (LV) systolic function and LV remodeling. We prospectively studied 30 patients (mean age: 58 ± 10 y.o., 77% men (23)) with paroxysmal (n=22) or persistent (n=8) AF, referred for pulmonary vein isolation. A control group of 15 patients without any cardiac disease, matched in age and sex, was also studied. All patients had echocardiographic study at baseline, at discharge and at 3-months follow-up (3M-f/up), using conventional Simpson’s method to assess LV volumes and LV ejection fraction (LVEF), and new tools, such DTI, strain and 2D-strain methods. 1) At baseline, AF patients had lower LVEF than controls (minus;9 %, p=.03), lower Sa (−28 %, p<.001) (Sa: LV systolic peak velocity measured by DTI) and lower LV global longitudinal strain (GLS) (−21 %, p=.004). 2) At 3M-f/u, there were no more differences in LVEF, nor in LV GS. While increased at 3M-f/up, Sa remained lower in AF patients than in controls (9.4±2.9 cm/s vs. 11.4±2 cm/s, p=.02). 3) Values were significantly lower in persistent AF compared to paroxysmal AF, for LVEF (51±12 % vs. 61±7 %, p= .006); Sa (8±2 cm/s vs. 8.5±2.2 cm/s, p=.004) and LV GLS (−12.4±5 % vs. −16.4±5 %, p=.02). Our study suggests that AF catheter ablation could have a favourable and early impact on LV remodelling, even in case of persistent AF.