Abstract 507: The Mechanism of Improvement of Cardiac Function in Patients With Atrial Fibrillation and Heart Failure After Pulmonary-vein Isolation
Background: Pulmonary-vein isolation (PVI) is reported to be effective in patients with heart failure (HF) and atrial fibrillation (AF), whereas the precise mechanism of PVI for AF with HF is unknown. We hypothesized that PVI for AF with HF improve longitudinal left ventricular (LV) function.
Methods: Thirty-seven consecutive AF patients who were treated with pulmonary-vein isolation (PVI) with radiofrequency catheter ablation (n = 37) were examined before and after PVI (day 2,3,4,7, and 30). In addition to routine echocardiographic assessment, LV global longitudinal strain from apical views and LV global circumferential strain from short-axis view of papillary muscle level were monitored. Improvement of cardiac function is defined as the improvement of stroke volume assessed by velocity-time integral of LV out tract flow velocity (LVOT-VTI).
Results: The LVOT-VTI and the ejection time of LVOT flow had been gradually improved after PVI. These improvements were independent with the progression of transmitral late diastolic flow velocity (TMF-A velocity: booster pump function). Multivariate analysis demonstrated that the % change in longitudinal LV systolic strains were most powerful predictors of LV stroke volume (R = 0.85~0.92, P<0.0001).
Conclusion: Longitudinal LV dysfunction improves after PVI in patients with AF and HF. These changes occur independent with the improvement of atrial booster pump function.