Reverse Left Atrial Remodeling after Radiofrequency Catheter Ablation for Non-Paroxysmal Atrial Fibrillation

Abstract

Background & Objectives: Restoration and maintenance of regular rhythm can be achieved by radiofrequency catheter ablation (RFCA) in patients with non-paroxysmal atrial fibrillation (non-PAF). However, it still remains undetermined whether this reversal is accompanied with amelioration of atrial function, which is associated with reduced risk of subsequent thromboembolic events. Methods: We studied 19 consecutive patients (age: 60±12 years) who had received RFCA for non-PAF. Serial changes in left atrial (LA) size and contraction were evaluated with echocardiography at baseline, 2 weeks, 3 months and 12 months after the procedure. Results: Fourteen of 19 patients had recovered and maintained regular rhythm during the follow-up. LA size and biplane volume index reduced over the time (p<0.01 and p<0.01, respectively). Atrial contractibility, assessed by time-velocity integral of atrial wave and atrial filling fraction (p<0.05 and p<0.05, respectively), was improved after the procedure. In addition, atrial compliance, assessed by peak systolic strain of LA inferior and septal wall (p<0.001 and p<0.001, respectively), was also improved over the time. These improvements of LA function were accompanied with that of left ventricular ejection fraction (p<0.001). Conclusion: Restoration and maintenance of regular rhythm achieved by RFCA was associated with reduction in atrial size and volume as well as improvement in contraction. Our findings may encourage usefulness of RFCA for non-PAF, expecting risk of reduction of subsequent thlomboembolic events.