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- Title
Long-term left atrial remodeling after ablation of persistent atrial fibrillation: 7-year follow-up by cardiovascular magnetic resonance imaging.
- Authors
Kriatselis, Charalampos; Unruh, Tatjana; Kaufmann, Jan; Gerds-Li, Jin-Hong; Kelle, Sebastian; Gebker, Rolf; Jahnke, Cosima; Paetsch, Ingo; Pieske, Burkert
- Abstract
<bold>Purpose: </bold>Restoration of sinus rhythm in patients with persistent atrial fibrillation (ps. AF) induces reverse atrial remodeling and improvement of left ventricular function. We evaluated the effect of ablative treatment on cardiac remodeling after a long follow-up period of 7 years by cardiovascular magnetic resonance (CMR).<bold>Methods: </bold>Patients with symptomatic ps. AF underwent CMR within 7 days prior to the ablation procedure. Left atrial and ventricular volumes were measured. All patients underwent circumferential pulmonary vein isolation. At the end of follow-up (FU), a CMR and 7-day ECG registration were performed.<bold>Results: </bold>Forty-two patients (67 ± 9 years) were included. After a FU of 86 ± 13 months, 23 patients had a successful outcome. In these patients, LVEF improved from 56 ± 5 to 62 ± 4% (p = 0.02), but left atrial volume and ejection fraction (LAV, LAEF) remained unchanged (105 ± 25 to 98 ± 34, p = 0.44; 34 ± 10 to 36 ± 11, p = 0.6, respectively). In 14 patients with a BMI < 30 and no left ventricular hypertrophy (LVH), LAV decreased (104 ± 30 to 82 ± 26 ml, p = 0.01) and LAEF improved (33 ± 12 to 40 ± 11%, p = 0.03). In 9 patients with successful outcome and either BMI ≥ 30 or LVH, LAV increased (110 ± 26 to 125 ± 30 ml, p = 0.03) and LAEF deteriorated (35 ± 11 to 31 ± 10%, p = 0.04).<bold>Conclusions: </bold>Successful ablative treatment of atrial fibrillation is associated with reverse left atrial remodeling and improvement of left atrial and ventricular function. In patients with a BMI ≥ 30 or left ventricular hypertrophy, further left atrial enlargement occurs despite successful outcome.
- Subjects
VENTRICULAR remodeling; CARDIAC magnetic resonance imaging; PULMONARY veins; ATRIAL fibrillation; LEFT ventricular hypertrophy; CATHETER ablation; MAGNETIC resonance imaging; TREATMENT effectiveness; LONGITUDINAL method
- Publication
Journal of Interventional Cardiac Electrophysiology, 2020, Vol 58, Issue 1, p21
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-019-00584-1