Atrial strain performance in patients with paroxysmal atrial fibrillation undergoing successful radio-frequency catheter ablation

Abstract

\n \n \n Type of funding sources: Public Institution(s). Main funding source(s): International PhD Program in Cardiovascular Pathophysiology and Therapeutics CardioPaTh\n \n \n \n Radio-frequency catheter ablation (CA) is associated with changes of left atrial (LA) structure and function. However, there is limited knowledge regarding the long-term impact of successful CA on atrial morphology and mechanics.\n \n \n \n To compare the time course of LA and right atrial (RA) performance in patients with paroxysmal atrial fibrillation (AF) undergoing the first CA.\n \n \n \n This prospective study included 89 consecutive patients (age:62\u2009±\u200921 years; 66% male) with a history of symptomatic AF who underwent successful CA. All patients maintained SR during follow-up. A comprehensive echocardiographic examination was performed 1- day before and 1-day, 3-month and 12-month after CA. The reservoir and contractile strain for both LA and RA (LAS, RAS), and left intra-atrial mechanical dispersion (LAMD) were assessed using 2D speckle tracking echocardiography in all three apical views (only 4CH view for RAS and LAMD).\n \n \n \n At baseline, all patients with paroxysmal AF showed a significant reduction of reservoir and contractile LAS and RAS compared with controls (all p\u2009<\u20090.01). CA was associated with a significant decrease in reservoir and contractile LAS while no significant difference was observed for RAS. At 3-month follow-up, the LAS showed full recovery, whereas the RAS did not show any significant change from 1-day post CA values. At 12-month follow-up, both reservoir and contractile LAS showed further improvement compared to baseline and 3-month values. LAMD derived from the LA strain curve followed a similar trend. Although the RA motion was not affected in the early phase, both reservoir and contractile RAS showed a significant increase between 3-month and 12-month follow-up.\n \n \n \n Although the radio-frequency CA affected negatively LA performance in the acute phase, it has a long-term positive impact on both left and right atrial function.\n \n \n \n Time course of reservoir and contractile LAS and RAS at Baseline, 1-day, 3-month and 12-month follow-up.\n Abstract Figure.\n