Abstract 17760: Short- and Long-Term Association of Atrial Fibrillation Catheter Ablation With Left Atrial Volume and Function: A Cardiac Magnetic Resonance Study
Introduction: Catheter ablation is widely used to improve rhythm control in patients with atrial fibrillation (AF). However, the short- and long-term changes in left atrial (LA) volume and function following ablation remain unknown.
Hypothesis: We hypothesized that AF ablation is associated with reduced LA volume and function.
Methods: 43 patients (73% paroxysmal, mean age 60 ± 9 years) with symptomatic AF underwent cardiac magnetic resonance (CMR) imaging at baseline, 1 day (n=12) and 9 ± 4 months after ablation (n=31). All patients were in sinus rhythm during baseline and follow up CMR exams. LA volumes, total LA emptying fraction (LAEF) and peak LA longitudinal strain were measured using tissue-tracking CMR. Patients were followed for recurrence of AF or atrial tachycardia using scheduled and symptom prompted ECGs.
Results: Compared to baseline values, maximum LA volume and peak LA strain were unchanged, minimum LA volume was larger (57 ± 19ml vs. 68 ± 23ml, P=0.039), and total LAEF and peak LA strain were reduced 1 day following ablation (47 ± 11% vs. 40 ± 9%, P=0.008 for total LAEF and 24 ± 6% vs. 22 ± 6%, p=0.031 for peak LA strain). During long-term follow-up of the 31 patients with long-term imaging, LA volumes and function were unchanged compared to baseline among patients with AF recurrence (n=16). However, maximum and minimum LA volumes were reduced (98 ± 21ml vs. 93 ± 18, P=0.034 and 57 ± 16ml vs. 53 ± 14ml, p=0.017 respectively), total LAEF was increased (41 ± 8% vs. 44 ± 7%, p=0.016), and peak LA strain was increased (24 ± 7% vs. 26 ± 6%, P= 0.01) among patients without AF recurrence (n=15).
Conclusions: Despite an immediate post procedural impairment of global LA function, long-term LA functional changes depend on restoration of sinus rhythm. Positive LA remodeling and improved function are notable among patients with successful AF ablation.
Author Disclosures: M. Habibi: None. E. Gucuk Ipek: None. J.A. Lima: None. S.L. Zimmerman: None. J. Rickard: None. H. Ashikaga: None. D. Spragg: None. J.E. Marine: None. R. Berger: None. H. Calkins: None. S. Nazarian: None.
- © 2016 by American Heart Association, Inc.