Background: Radio frequency ablation (RFA)is an important treatment option for patients with atrial fibrillation (AF). During RFA, a significant amount of energy is delivered into the left atrium (LA), resulting in considerable LA-injury. The impact of this damage on mechanical and endocrine LA-function, however, is often disregarded. We therefore aimed to evaluate the endocrine- and mechanical function of the heart 4-months after RFA of AF.
Methods: In total, 189 patients eligible for RFA of AF were studied. The levels of the N-terminal pro-B-natriuretic peptide (NT-proBNP) and the mid-regional fragment of the N-terminal pro-atrial natriuretic peptide (MR-proANP) were measured. The maximum LAvolume (LAVmax), the LAejection fraction (LAEF) and the LA peak longitudinal strain (PALS), were measured using transthoracic echocardiography. The measurements were performed before and 4-months after the intervention.
Results:87 patients had a recurrence during a mean follow-up of 143±36 days. NT-proBNP and MR-proANP decreased significantly at follow-up. This reduction was greater in patients who did not suffer any recurrence after RFA.
The LAVmax decreased significantly, where as the PALS only improved in patients who did not suffer from any recurrence. On the other hand, LAEF did not change significantly after RFA of AF.
Conclusions: Despite extensive ablation during RFA of AF, the endocrine function of the heart improved 4-months after the index procedure. Patients with no arrhythmia recurrence showed a more pronounced improvement in their endocrinal function. Mechanically, the LAV max was reduced, and the LA strain improved significantly.
Credits: Matthew T. Brown , Soroosh Kiani , George B. Black , Marvin LR Lu , Neal Bhatia , Michael Lloyd , Anand Shah, Stacy Westerman, Faisal M. Merchant, Mikhael F. El-Chami