Abstract 9692: A 2D Speckle Tracking Echocardiography Demonstrates Improvement of Left Atrial and Ventricular Strain After Ablation in Patients with Atrial Fibrillation;
Introduction: Recent echocardiographic studies have shown that strain analysis of the myocardium is a very sensitive method for detecting various pathophysiological changes before and after cardiovascular interventional procedures. We hypothesized that a 2D speckle tracking imaging can quantify the damage of the left atrial (LA) and left ventricular (LV) myocardium in patients with atrial fibrillation (AF), and demonstrate improvement of atrial and ventricular function after ablation procedure.
Methods: We performed catheter ablation guided by CARTO navigation (extensive encircling pulmonary vein isolation) in 35 patients with AF (paroxysmal, n=23; persistent, n=12). LA and LV longitudinal strain in systolic phase by 2D speckle tracking echocardiographic imaging and 24-hour Holter ECG were evaluated at baseline before ablation and various follow-up time points (1 day, 1 month, and 3 months after ablation). Those without AF who underwent catheter ablation for other indications served as a control group (n=22).
Results: Patients with persistent AF had significantly lower LA and LV longitudinal strain at baseline than those with paroxysmal AF and the control (LA, 14.9±6.5% vs 40.4±18.6% and 41.2±21.8%, p<0.001; LV, -15.0±6.4% vs -21.1±3.3% and -21.2±1.7%, p<0.05). In those with persistent AF, LV longitudinal strain returned to the normal value of -20.4±2.6% 1 month after ablation, and subsequently, LA strain was also improved to the value of 40.0±18.9% 3 months after ablation. At the most recent follow-up, 77% of the patients with AF maintained sinus rhythm on Holter ECG.
Conclusions: Restoration and maintenance of sinus rhythm by catheter ablation in patients with persistent AF improves both LA and LV strain in a time-dependent manner. A 2D speckle tracking imaging can demonstrate improvement of atrial and ventricular function after ablation procedure.G009692
- © 2011 by American Heart Association, Inc.