Abstract 16964: The Functional Remodeling of Left Atrium After Ablation in Paroxysmal Atrial Fibrillation
Background: Reverse structural remodeling of left atrium (LA) ensues after successful radiofrequency catheter ablation (RFCA). But the functional reverse remodeling after RFCA has not been well studied. The purpose of this study was to clarify the impact of RFCA on LA phasic function in paroxysmal AF (PAF) by comparing two groups of PAF (who maintained sinus rhythm (SR) vs recurred AF after RFCA).
Methods: 89 PAF patients (F/M=26/63, mean age=57.3±10.0yrs) who were initially cardioverted after RFCA and age, gender matched 15 normal controls were studied. Patients were devided into 2 groups(Group1;maintenance of SR, Group2;recurred AF, during 1 year follow-up) for analysis. 2D-echocardiography was performed before ablation as a baseline and follow up examination was done at 1yr after RFCA. The size and function of left ventricle and LA and 3 LA phasic function(reservoir, conduit, pump function) were evaluated. All echocardiographic parameters were assessed during sinus rhythm.
Results: Group 1 were 62 patients(70%) and 27 patients(30%) were Group 2. The age and sex between 2 groups were similar. In Group1 and 2, the size of LA was larger and 3 LA phasic functions were worse than that of normal control at baseline, without difference between 2 groups. At 1 year after ablation, LA size was decreased and LA reservoir and pump function were improved in Group1, but were lower than normal values. LA size was not changed in Group2 at 1 year. Moreover, LA reservoir function of was progressively worsened after 1yr(41.3±6.3 vs 34.8±11.9, p-value: 0.029) in Group2 (Table 1).
Conclusion: Reverse functional remodeling of LA was observed after successful RFCA as well as LA structural remodeling in PAF. But diminished LA reservoir function was progressed during 1 year without structural remodeling of LA who recurred AF. These findings suggest early management of PAF may be beneficial before the irreversible left atrial functional remodeling process ensues.
- © 2013 by American Heart Association, Inc.