Effects of radiofrequency catheter ablation on left ventricular structure and function in patients with atrial fibrillation: a meta-analysis

Abstract

RFCA in AF patients could reverse LV structural remodeling and improve LV systolic function, especially in patients with low LVEF and chronic AF.

The Impact of Known Heart Disease on Long‐Term Outcomes of Catheter Ablation in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction: A Multicenter International Study

“…Several studies have demonstrated significant improvements in LVEF following AF ablation, particularly in patients with no known cause of cardiomyopathy, , although few have sought specifically to evaluate the population with KHD. Hsu et al .…”

“…Several studies have demonstrated significant improvements in LVEF following AF ablation, particularly in patients with no known cause of cardiomyopathy, 4,5,[18][19][20][21] although few have sought specifically to evaluate the population with KHD. Hsu et al found patients with "concurrent structural heart disease" had significant improvements in LVEF post-ablation although to a significantly lesser extent than those without (16 ± 14% vs. 24 ± 10%, P = 0.007 for comparison).…”

Atrial ectopy after pulmonary vein isolation and left heart reverse remodeling in patients with atrial fibrillation

“…As for LV reverse remodeling, Reant et al demonstrated significant improvement of LVEF 1 year after PVI in 48 patients with isolated AF . A recent meta‐analysis including 21 studies (1135 patients) confirmed that catheter ablation for AF improved the LVEF . Further, Kim et al showed significant LV mass reduction in 35 patients without AF recurrence after PVI .…”

“…The occurrence of AF initiates a vicious cycle propagating further LA and LV remodeling, and consequently worsening of AF . Circumferential PVI is considered a reasonable treatment option for patients with symptomatic drug‐refractory AF, and successful PVI is known to be associated with beneficial effects on LA and LV remodeling. Tops et al showed significant LA size reduction at 3 months after PVI in patients without AF recurrence using echocardiography .…”

“…[1][2][3][4] Because pulmonary veins (PVs) are important sources of the ectopic beats that initiate AF, 5 circumferential PV isolation (PVI) was reported to be effective for patients with symptomatic drug-refractory AF. [6][7][8][9] Whether this remodeling is the cause or the consequence of the AF remains debatable; maintenance of sinus rhythm after successful PVI is known to be associated with a decrease in LA volume, [10][11][12] improved LV ejection fraction (EF), 13,14 and LV mass reduction, 15 namely "reverse remodeling," although the degree of reverse remodeling varies among individuals.…”