Abstract 15909: The Clinical Factors Affecting the Left Ventricular Systolic and Diastolic Functions After Catheter Ablation of Atrial Fibrillation: 1 Year Echocardiography Follow-Up Study
Introduction: Loss of atrioventricular synchrony has been known to impair left ventricular (LV) systolic and diastolic function in patients with atrial fibrillation (AF), and radiofrequency catheter ablation (RFCA) may recover them.
Hypothesis: We explored the clinical factors affecting the reverse LV systolic and diastolic functions after RFCA for AF.
Methods: We compared pre- and post-1-year RFCA follow-up echocardiography in 521 patients with AF (male 76.2%, 57.1±11.2 years old, paroxysmal AF 68.5%) who underwent RFCA. Left ventricular (LV) systolic and diastolic functions were estimated by ejection fraction (EF) and the ratio of the early transmitral flow velocity (E) and early mitral annular velocity (Em), respectively.
Results: 1. AF ablation significantly reduced left atrium volume index (p<0.001) and improved LVEF (p=0.008 and p<0.001) in both recurred (n=133) and non-recurred patients (n=388). 2. In patients with baseline E/Em<15 (n=454), significant EF improvement was observed (63.2±8.0 to 65.1±6.9%, p<0.001). In the group with pre-procedural E/Em[[Unable to Display Character: ]]15 (n=67), E/Em was reduced (19.6±7.0 to 16.2±6.1, p=0.008). 3. For EF improvement, baseline lower EF (B=-0.53, 95% CI -0.60~-0.46, p<0.001), lower E/Em (B=-2.89, 95% CI -4.73~-1.06, p=0.002), and female gender (B=-2.13, 95% CI -3.55~-0.72, p=0.003) were independently associated. For E/Em reduction, younger age (B=-0.07, 95% CI -0.11~-0.03, p=0.002) and pre-procedural higher E/Em (B=4.621, 95%CI 3.15~6.09, p<0.001) were statistically associated.
Conclusions: AF catheter ablation improves LV systolic function at 1-year follow-up, especially in patients with low pre-procedural EF, low E/Em, or female gender. The improvement of LV diastolic function was related to young patients with baseline LV diastolic dysfunction.
Author Disclosures: I. Kim: None. H. Mun: None. J. Uhm: None. B. Joung: None. M. Lee: None. H. Pak: None.
- © 2014 by American Heart Association, Inc.