Effect of Catheter Ablation for Isolated Paroxysmal Atrial Fibrillation on Longitudinal and Circumferential Left Ventricular Systolic Function

Réant, Patricia; Lafitte, Stéphane; Bougteb, Hanane; Sacher, Frédéric; Mignot, Aude; Douard, H.; Blanc, Pierre; Hocini, Mélèze; Clémenty, Jacques; Haı̈ssaguerre, Michel; Roudaut, Raymond; Jaı̈s, Pierre

doi:10.1016/j.amjcard.2008.08.070

Cited by 31 publications

(33 citation statements)

References 23 publications

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“…34 We previously demonstrated that a reduction in GLS can be in fact associated with a lower LA reservoir function, 35 which has in turn been demonstrated to be a strong predictor of development of first-onset AF. 36 In line with our findings, a previous study reported lower GLS but similar LVEF in patients with paroxysmal AF compared to healthy controls; 37 therefore it is possible that an impaired GLS may in some cases be associated with undiagnosed paroxysmal AF, progressing toward permanent AF over time, an hypothesis that deserves further investigation.…”

Section: Discussionsupporting

confidence: 90%

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation

Russo

Jin

Sera

et al. 2015

Circ: Cardiovascular Imaging

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Background The increasing prevalence of atrial fibrillation (AF) represents a public health issue. Identifying new predictors of AF is therefore necessary to plan preventive strategies. We investigated whether left ventricular (LV) systolic dysfunction by global longitudinal strain (GLS), a predictor of cardiovascular events, may predict new-onset AF in a population setting. Methods and Results Participants (n=675, mean age 71±9 years, 60% women) in sinus rhythm from the population-based Northern Manhattan Study underwent two- and three-dimensional echocardiography as part of the Cardiac Abnormalities and Brain Lesions (CABL) study. LV systolic function was assessed by LV ejection fraction (LVEF) and speckle-tracking GLS. Over a mean follow-up of 63.6±18.7 months, 32 (4.7%) new confirmed cases of AF occurred. Lower GLS [adjusted hazard ratio (aHR)/unit decrease=1.22, 95% confidence interval (CI)=1.04-1.43, p=0.015] and increased left atrial volume index (LAVi) (aHR/unit increase=1.12, 95% CI=1.07-1.17, p<0.001) were significantly associated with incident AF, whereas LVEF was not (p=0.176). GLS>-14.7% was associated with risk of new-onset AF with an aHR=3.2 (95% CI=1.4-7.5, p=0.007). The coexistence of abnormal GLS/abnormal LAVi was associated with a 28.6% incidence of AF (aHR=12.1, 95% CI=3.3-44.8, p<0.001) compared to participants with normal GLS/normal LAVi (AF incidence=2.0%). AF incidence was intermediate in those with either abnormal GLS or abnormal LAVi (9.3% and 11.1%, respectively). GLS prognostic value for incident AF was incremental over risk factors and LAVi. Conclusions LV systolic dysfunction by GLS was a powerful and independent predictor of incident AF. GLS assessment may improve AF risk stratification in addition to established parameters.

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Section: Discussionsupporting

confidence: 90%

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation

Russo

Jin

Sera

et al. 2015

Circ: Cardiovascular Imaging

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“…been shown that in patients with lone AF, subtle abnormalities of systolic and diastolic function are present that improve after AF ablation. 25,26 In the present study, we found that a clinically meaningful increment of improvement in LVEF (by 5%) after ablation occurred in the majority of patients with systolic dysfunction. One third of patients with LV systolic dysfunction appeared to have tachycardia-induced cardiomyopathy, given the restoration of LVEF to normal or near normal after ablation.…”

Section: Reversibility Of Left-sided Cardiomyopathy With Ablationmentioning

confidence: 63%

Success of Ablation for Atrial Fibrillation in Isolated Left Ventricular Diastolic Dysfunction

Cha

Wokhlu

Asirvatham

et al. 2011

Circ: Arrhythmia and Electrophysiology

140

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Background-The efficacy of radiofrequency ablation for atrial fibrillation (AF) in patients with left ventricular (LV) systolic dysfunction and isolated diastolic dysfunction is uncertain. Methods and Results-A prospective cohort of patients with normal and abnormal LV function underwent ablation for antiarrhythmic drug (AAD)-refractory AF. Three groups were compared: 111 patients with systolic dysfunction, defined as LV ejection fraction (LVEF) Յ40%; 157 patients with isolated diastolic dysfunction but preserved LVEF Ն50%; and 100 patients with normal LV function. The primary end point was AAD-free AF elimination at 1 year after ablation. This end point was achieved in 62% of patients with systolic dysfunction, 75% of those with diastolic dysfunction, and 84% of controls (Pϭ0.007). AF control on or off AADs was achieved in 76% of patients with systolic dysfunction, 85% of those with diastolic dysfunction, and 89% of controls (Pϭ0.08).In the systolic dysfunction group, 49% experienced an increase in LVEF by Ն5% after ablation, of which 64% achieved normal LVEF. In the diastolic dysfunction group, 30% of patients demonstrated at least 1 grade improvement in diastolic dysfunction. Multivariable analysis demonstrated an increased relative risk of arrhythmia recurrence of 1.8 (95% CI, 1.1 to 3.1; Pϭ0.02) in systolic dysfunction and 1.7 (1.0 to 2.7; Pϭ0.04) in isolated diastolic dysfunction compared with normal function. Conclusions-Although an ablative approach for AF in patients with systolic or diastolic dysfunction is associated with an increased long-term recurrence risk, there is potential for substantial quality-of-life improvement and LV functional benefit. (Circ Arrhythm Electrophysiol. 2011;4:724-732.)

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“…Other studies showed improvement in LV function independent of adequate rate control [9,19]. In addition to these favorable clinical outcomes, improvement in LV longitudinal and circumferential strain was also observed [11,12]. Hsu et al [5] suggested that the restoration of sinus rhythm resulted in an overall increase in the LVEF in patients with congestive HF.…”

Section: Discussionmentioning

confidence: 87%

“…It has been suggested that the restoration and maintenance of sinus rhythm by CA improves left ventricular (LV) function, symptoms, exercise capacity, and quality of life in patients with congestive heart failure (HF) and AF [9]. Also, reverse-remodeling of the left atrium (LA) and improved LV systolic and diastolic functions were also observed following CA in patients with isolated AF [11,12]. However, few studies have directly compared echocardiographic parameters in regard to LV remodeling in AF patients treated with CA versus antiarrhythmic drugs.…”

Section: Introductionmentioning

confidence: 99%

Effect of catheter ablation on the left ventricular mass index and other echocardiograph parameters in atrial fibrillation patients: comparison with antiarrhythmic drug treatment

Kim

Nam

et al. 2010

J Echocardiogr

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Effect of Catheter Ablation for Isolated Paroxysmal Atrial Fibrillation on Longitudinal and Circumferential Left Ventricular Systolic Function

Cited by 31 publications

References 23 publications

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation

Success of Ablation for Atrial Fibrillation in Isolated Left Ventricular Diastolic Dysfunction

Effect of catheter ablation on the left ventricular mass index and other echocardiograph parameters in atrial fibrillation patients: comparison with antiarrhythmic drug treatment

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