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- Title
Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1-Year Follow-Up Multislice Computed Tomography Study.
- Authors
KIM, JIN‐SEOK; IM, SUNG IL; SHIN, SEUNG YONG; KANG, JUN HYUK; NA, JIN OH; CHOI, CHEOL UNG; KIM, SEONG HWAN; KIM, EUNG JU; RHA, SEUNG‐WOON; PARK, CHANG GYU; SEO, HONG SEOG; OH, DONG JOO; HWANG, CHUN; KIM, YOUNG‐HOON; YONG, HWAN SEOK; LIM, HONG EUY
- Abstract
LA Functional Remodeling After AF Ablation Background Functional remodeling of left atrium (LA) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has not been fully elucidated. This study aimed to determine the impact of RFCA on LA transport function in patients who maintained sinus rhythm (SR) after AF ablation. Methods and Results A total of 96 patients (paroxysmal AF [PAF] = 52) who maintained SR during 1 year after AF ablation were enrolled. Multislice computed tomography was performed to determine LA volume (LAV) and LA emptying fraction (LAEF) at pre-RFCA and 1-year post-RFCA. Creatine kinase-MB (CK-MB) and troponin-T levels were analyzed 1-day post-RFCA. At 1-year post-RFCA, mean LAV and LAEF decreased in overall patients. Based on LAEF change (ΔLAEF) cutoff of 5.0%, LAEF reduced in 41 patients (worsened group) and improved or showed no change in 55 patients (preserved group). Compared with preserved group, worsened group had a higher proportion of PAF, higher levels of CK-MB and troponin-T, and additional LA ablation. ΔLAEF was inversely correlated with CK-MB and troponin-T levels. Subgroup analysis showed that LAEF significantly decreased in PAF patients who underwent additional LA ablation. Multivariate analysis revealed that high baseline LAEF and additional LA ablation were independent predictors for worsened LAEF. Conclusions Although SR was maintained for 1 year after AF ablation, LAEF as well as LAV decreased. The extent of LAEF deterioration was significantly associated with the amount of iatrogenic myocardial damage. Our data indicate that extensive atrial ablation may lead to LA functional deterioration, especially in patients with PAF.
- Subjects
ATRIAL fibrillation; CARDIOVASCULAR diseases; CATHETER ablation; STATISTICAL correlation; HEART atrium; LONGITUDINAL method; MEDICAL protocols; MULTIVARIATE analysis; NONPARAMETRIC statistics; T-test (Statistics); DISEASE relapse; DATA analysis software; TROPONIN; MULTIDETECTOR computed tomography; MANN Whitney U Test
- Publication
Journal of Cardiovascular Electrophysiology, 2017, Vol 28, Issue 2, p167
- ISSN
1045-3873
- Publication type
Academic Journal
- DOI
10.1111/jce.13128