Abstract 12947: Restoration of Sinus Rhythm Significantly Improves Left Ventricular Function in Patients With Very Low Ejection Fraction

Abstract

Introduction: Left ventricular (LV) dysfunction is a common sequelae of supraventricular tachycardia, especially atrial fibrillation (AF). We evaluated the impact of restoration of sinus rhythm following successful catheter ablation on LV function in AF patients with ejection fraction of ≤20%. Methods: Consecutive AF patients with LVEF ≤20% undergoing their first catheter ablation were included in the study. All received isolation of pulmonary veins, left atrial posterior wall and superior vena cava. Additionally, non-PV triggers were ablated at the operator’s discretion. Echocardiogram was performed at baseline and 6 months post-ablation to measure the LVEF. Arrhythmia-monitoring was performed at 1, 3 and 6 months with event recorders, 12-lead ECG and 7-day Holter monitoring. Results: A total of 63 patients undergoing catheter ablation for AF were included (age: 62.5 ± 9.9 years, male: 82.5%). Majority of the patients had LVEF of ≤15% (n=48, 76%); remaining 15 patients had LVEF of 16-20%. Mean LA diameter was 4.94 ± 0.57 cm and 82.5% of patients had non-paroxysmal type of AF. Median duration of AF was 27 months. Follow-up echocardiogram at 6 months of follow-up detected significant improvement in LVEF [Mean difference: 15.2 ± 11.7% (p < 0.001)]. All patients were arrhythmia-free at that time point: 47 (74.6%) off-drugs and 16 (25.4%) patients on previously ineffective anti-arrhythmic drugs. Conclusion: Restoration of sinus rhythm following successful catheter ablation was associated with significant improvement in LVEF in patients with severe LV dysfunction