Cardiologie clinique et expérimentale
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Altered Cardiac Performance Following Catheter Ablation in Patients with Non-Recurrence Persistent Atrial Fibrillation

Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Keisuke Ueno, Soki Inoue, Kentaro Mine and Shiro Hoshida

We aimed to elucidate the relationship between echocardiographic data after ablation and atrial fibrillation (AF) recurrence, and to examine the difference in this relationship between paroxysmal and persistent AF. We enrolled 105 patients (72 men, paroxysmal/persistent 56/49, mean age 67 years) who underwent a single radiofrequency catheter ablation procedure. The transthoracic echocardiographic parameters were measured before ablation and at 3 days/6 months after ablation. Recurrence was observed in 30 patients (29%) at 12 months (paroxysmal 18%, persistent 41%). Stroke volume index (SVI) increased significantly in recurrence-free patients only with persistent AF shortly after ablation. Patients with persistent AF showing an increase in tricuspid regurgitation pressure gradient (ΔTRPG>0) exhibited an increase in SVI after ablation and a lower incidence of recurrence at 12 months than those with ΔTRPG<0. At 6 months after ablation, the altered levels of TRPG, but not SVI, were restored to the levels before ablation. In conclusion, a persistent increase in SVI associated with transiently increased TRPG at 3 days after ablation in patients with persistent AF, but not with paroxysmal AF, represents preserved cardiac performance of the entire heart and not just the left atrium, possibly related to the incidence of recurrence thereafter in patients with persistent AF.