Abstract 11717: Speckle Tracking Echocardiographic Analysis for Impact of Pulmonary Vein Isolation on Left Atrial Volume and Function in Patients with Chronic Atrial Fibrillation
Background.Indication for pulmonary vein isolation (PVI) has been expanded from paroxysmal atrial fibrillation to chronic AF (CAF). However, the effect of PVI on left atrial volume (LAV) and LA function in patients with CAF has not yet been clarified. This study was designed to evaluate the impact of maintaining sinus rhythm by PVI on LAV and LA function in patients with CAF.
Methods. Sixty patients with CAF and PVI (age 61±10 years, Male 80%) were enrolled.The duration of AF was 4.9±4.7yrs. All patients maintained sinus rhythm for more than 1 year after PVI. Echocardiographic examinations including by speckle tracking echocardiography(STE) were repeated at baseline, 1 week after, and 12 months after PVI. LAV was calculated by bi-plane Simpson's method. Maximum LAV at end-left ventricular (LV) systole, LAV at pre-atrial contraction, and minimum LAV at LV end-diastole were assessed. LA ejection fraction (LAEF) was calculated as follows; (LAV at pre-atrial contraction - minimum LAV) / LAV at pre-atrial contraction. Peak LA longitudinal strain (LA-LS) and strain-rate(LA-LSR) by STE during LV systole were measured to assess LA reservoir function as well as the difference between the maximum and minimum LAV (ΔLAV max-min). LA-LSR at atrial contraction was measured to assess LA booster pump function as well as LAEF.
Results. Since almost all patients were AF at the baseline evaluations, baseline LAV at pre-atrial contraction and LA booster pump function could not be assessed. As shown in the table, each LAV decreased over time. ΔLAV max-min and peak LA-LS at LV systole did not significantly change, however, peak LA-LSR at LV systole was increased. As for LA booster pump function, LAEF did not changed over time. In contrast, peak LA-LSR at atrial contraction was increased.
Conclusions.In patients with CAF, PVI produces LA reverse remodeling and improvements of LA reservoir and booster pump function, which could be detected by STE derived strain-rate analysis.
- © 2011 by American Heart Association, Inc.