REVERSE LEFT ATRIAL REMODELING ASSESSMENT AFTER PAROXYSMAL ATRIAL FIBRILLATION ABLATION: OUR FIRST EXPERIENCE
Keywords:
ATRIAL FIBRILLATION, LEFT ATRIUM, VOLUME, REMODELINGAbstract
We aimed to assess reverse left atrial (LA) remodeling at 6 months after ablation of paroxysmal atrial fibrillation (AF), and to identify the most relevant parameter of reverse LA remodeling. Ma-terial and methods: Left atrial size was assessed by echocardiography: antero-posterior (AP) diameter, LA area in apical 4 and 2 chambers (A4c, A2c), LA volume by biplane for-mula (LAV1), and by computed-tomography (LAV2). Results: Seventy-eight consecutive patients with mean age of 57.41 ± 8.05 years were prospectively included; 60 (76.9%) were with paroxysmal AF less than 24 hours and 18 (23.1%) less than 7 days duration. All echo-cardiographic and computed-tomographic evaluations were made within 4 weeks before ab-lation and at 6 months after ablation procedure by the same operator. Circumferential or segmental pulmonary vein isolation was performed by radiofrequency in 58 (74.4%) pa-tients, and by cryotherapy in 18 (23.1%) patients. At 6 months 53 (67.9%) patients were in stable sinus rhythm and 18 (23%) out of those on antiarrhythmic drugs. At 6 months after ablation all parameters of LA size decreased statistically significant. Conclusions: In our first experience, endocardial catheter ablation results in significant conversion in sinus rhythm in patients with paroxysmal AF. The maintenance of stable sinus rhythm after abla-tion procedure determined a significant reverse LA remodeling, irrespective of parameter used for LA size assessment. The most relevant parameter for assessing reverse LA remodel-ing in patients with endocardial ablation of paroxysmal AF was LA volume by echocardiog-raphy.
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