Yonsei Med J.  2014 Jul;55(4):895-903. 10.3349/ymj.2014.55.4.895.

The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

• Chin JY
• Youn HJ

• KMID: 2130812
• DOI: http://doi.org/10.3349/ymj.2014.55.4.895

Abstract

PURPOSE
The effect of radiofrequency catheter ablation (RFCA) on left atrial (LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) has not been extensively studied. The aim of this study was to evaluate the long-term impact of RFCA on LA volume and function in patients with PAF.
MATERIALS AND METHODS
A total of 90 patients with drug-refractory PAF who had sinus rhythm on the initial echocardiogram were examined at baseline, 3 months and 1 year after ablation. We measured LA volume index, LA ejection fraction (LAEF; maximal-minimal LA volume/maximal LA volume), and LA active emptying fraction (LAAEF; mid-diastolic-minimal LA volume/mid-diastolic LA volume).
RESULTS
After 12+/-1 months, 78 patients returned, and 61 patients (78%) had sinus rhythm. After 3 months, the LA maximal volume indices decreased (from 33+/-13 to 28+/-12 mL/m2; p<0.001). But, LAEF and LAAEF also decreased (from 48+/-13 to 39+/-12; p<0.001, from 27+/-13 to 19+/-11; p<0.001). After 1 year, LA volumes, LAEF, and LAAEF remained similar at 3 months. In patients without atrial fibrillation (AF) recurrence, LAEF and LAAEF decreased after 3 months (from 50+/-12 to 40+/-11; p<0.001, from 29+/-13 to 22+/-11; p<0.001) and did not change after 1 year. However, in patients with AF recurrence, those who did not have decreased levels after 3 months had significantly decreased after 1 year (from 43+/-14 to 34+/-11; p=0.026, from 22+/-12 to 15+/-10; p=0.012).
CONCLUSION
Successful RFCA of PAF decreased LA volume and function at 3 months. At one year, LA volume and function was remained unchanged in successfully ablated patients whereas LA function in patients with AF recurrence worsened.

Keyword

Atrial fibrillation; ablation; left atrium

MeSH Terms

Adult
Aged
Atrial Fibrillation/*therapy
Atrial Function, Left/*physiology
*Catheter Ablation
Echocardiography
Female
Humans
Male
Middle Aged
Retrospective Studies

Figure

• 

  Fig. 1 (A) LA diameters in all patients, (B) AP diameter, (C) ML diameter, (D) SI diameter in the SR and AF groups at baseline, after three months, and after one year. *p<0.05, baseline versus follow-up parameters, †p<0.05, SR group versus AF group. AP diameter, anterior-posterior diameter; ML diameter, medial-lateral diameter; SI diameter, superior-inferior diameter; LA, left atrial; SR, sinus rhythm; AF, atrial fibrillation.

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  Fig. 2 (A) LA volume index in whole patients (B) LAVImax (C) LAVImid (D) LAVImin in the SR and AF groups at baseline, after three months, and after one year. *p<0.05 baseline versus follow-up parameters, †p<0.05 SR group versus AF group. LAVImax, left atrial maximal volume index; LAVImid, left atrial mid-diastolic volume index; LAVImin, left atrial minimal volume index; LA, left atrial; SR, sinus rhythm; AF, atrial fibrillation.

• 

  Fig. 3 (A) LAEF and LAAEF of whole patients (B) LAEF (C) LAAEF in the SR and AF groups at baseline, after three months, and after one year. *p<0.05 baseline versus follow-up parameters, †p<0.05 SR group versus AF group. LAEF, left atrial ejection fraction; LAAEF, left atrial active emptying fraction; SR, sinus rhythm; AF, atrial fibrillation.

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