Abstract 14126: Improvement in Left Ventricular Diastolic Parameters Following Catheter Ablation of Atrial Fibrillation
Introduction: Atrial fibrillation (AF) is commonly associated with impaired ventricular relaxation and heart failure with preserved ejection fraction. The effect of catheter ablation of atrial fibrillation on left atrial (LA) size and function and left ventricular (LV) diastolic filling is not well known.
Hypothesis: We studied the relationship of atrial size and LV diastology before and after ablation, and hypothesized that atrial size and LV filling parameters will improve after catheter ablation of AF.
Methods: Patients presenting for catheter ablation of AF were included in this study. Baseline atrial volume was obtained from pre-procedural CT or MR imaging while LV filling parameters, including mitral valve inflow velocities and tissue Doppler, were assessed using transthoracic echocardiography. The same measures were repeated 3 months following catheter ablation.
Results: Two hundred and ninety three patients (60.8% male) were included in the study. 178 patients (60.7%) had paroxysmal AF. The mean LV ejection fraction was 58±12%. At baseline, the mean LA volume was 94±38ml and the estimated mean LV filling pressure (E/E’) was 9.5±3.9. Ventricular relaxation pattern was identified as normal in 86 patients (52.1%), impaired in 36 (21.8%), pseudo-normal in 29 (17.6%) and restrictive in 14 (8.5%). Post ablation, the mean LA volume significantly decreased (94±38 ml to 84±34 ml; p<0.01). Mitral inflow A waves decreased from 0.70±0.23 to 0.38±0.31 post ablation (p<0.01) and E/E’ decreased from 9.5±3.9 to 5.6±5.1 (p<0.05). Post ablation, LV relaxation patterns were identified as normal in 122 patients (55.0%), impaired in 27 (12.2%), pseudo-normal in 60 (27.0%) and restrictive in 13 (5.9%). A total of 41 patients (27.2%) were determined to have improved diastolic filling patterns post ablation.
Conclusions: Catheter ablation of atrial fibrillation is associated with decreased LA volumes, improved LV relaxation patterns and improved LV filling pressures.
- © 2013 by American Heart Association, Inc.