492 LA mechanical function and LV systolic/diastolic parameters change in patients treated with ablation procedure for atrial fibrillation with no or minimal structural heart disease. A prospective 7 mont

Abstract

s S77 Eur J Echocardiography Abstracts Supplement, December 2006 492 LA mechanical function and LV systolic/diastolic parameters change in patients treated with ablation procedure for atrial fibrillation with no or minimal structural heart disease. A prospective 7 mont A. Drzewiecka -Gerber 1 ; A.M. Wnuk-Wojnar 2 ; I. Wozniak-Skowerska 2 ; J. Krauze 2 ; A. Rybicka-Musialik 2 ; S. Nowak 2 ; C. Czerwinski 2 ; M. Trusz-Gluza 2 1Katowice, Poland; 2I Klinika Kardiologii, SPSK nr 7, Ziolowa 47, Katowice, Poland Background: Hemodynamics of isolated atrial fibrillation (AF) is belived to be associated with slight enlargement of left atrial (LA) size and minor degree of left ventricular (LV) diastolic dysfunction, that is presumed rather to be a result than a cause of so called „lone AF”. Positive impact of sinus rhythm restoration by catheter ablation on LA size and LV function remains unclear. Methods and results: A group of 29 consecutive patients with no or minimal structural heart disease (mean LVEF 64±5%) treated with catheter ablation according to Pappone technique were included into prospective followup study. Mean age was 47±11 yrs, 17 patients had paroxysmal and 12 persistent AF. 11 patients (37%) had mild structural disease (7 hypertension, 4 coronary artery disease). TTE was performed at baseline and after mean time of 208±73 days follow-up. Conventional parameters, such as: LVEF, left atrium end systolic area(LAs area), left atrium emptying fraction (LAEF%), left atrium filling fraction (LAFF); E/A mitral flow ratio; as well as „new” diastolic/systolic indexes such as tissue Doppler imaging peak velocity of mitral annulus motion (TDI), Tei index, tissue tracking of anterior and posterior mitral leaflet, color M-mode propagation velocity were derived at baseline and followup examination. 20 patients (68%) demonstrated no arrhythmia recurrences at follow-up (AF negative group), whereas 9 patients (32%) had AF episodes confirmed in ECG Holter monitoring. Echo baseline parameters did not differ between the groups. At follow-up examination, however, a significant LVEF improvement was observed in AF negative group versus AF positive group (68±5 versus 65±5; p=0.02); as well as significant growth in TDI peak velocity in AF negative versus AF positive group (12±2 versus 9±1 cm/s, respectively, p=0.01). Analyzing AF positive and negative group, a significant positive trend in LVEF improvement in AF negative group was observed at followup comparing to baseline (68±5% versus 65±5%, respectively, p=0.06). LAEF improved significantly in AF negative group at follow-up comparing to baseline (64±14% versus 59±10%, respectively, p=0.003) as did TDI early peak velocity (12±2 cm/s versus 10±1 cm/s, respectively, p=0.002). Propagation velocity also increased in AF negative patients (54±11 cm/s versus 46±10 cm/s, respectively, p=0.008). Conclusions: This study demonstrates , that successful restoration of sinus rhythm in patients with lone AF treated with ablation procedure results in significant improvement of LA and LV functional parameters, that can be easily measured by echocardiography.