Reversal of Left Ventricular Dysfunction Following Ablation of Atrial Fibrillation

Gentlesk, Philip J.; Sauer, William H.; Gerstenfeld, Edward P.; Lin, David; Dixit, Sanjay; Zado, Erica S.; Callans, David J.; Marchlinski, Francis E.

doi:10.1111/j.1540-8167.2006.00653.x

Cited by 241 publications

(129 citation statements)

References 36 publications

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“…Permanent AF has been regarded as a potentially reversible cause of LV systolic dysfunction due to both shortening of the systolic interval and loss of the atrial contraction-mediated Frank-Starling mechanism (36). In the present study, at the end of follow-up there was a trend toward a lower LVEF in subjects who experienced first AF and died as compared to those who experienced first AF and survived.…”

Section: Discussionsupporting

confidence: 48%

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Benchimol-Barbosa

Barbosa-Filho

2009

Braz J Med Biol Res

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Atrial fibrillation (AF) affects subjects with Chagas' disease and is an indicator of poor prognosis. We investigated clinical, echocardiographic and electrocardiographic variables of Chagas' disease in a long-term longitudinal study as predictors of a new-onset AF episode lasting >24 h, nonfatal embolic stroke and cardiac death. Fifty adult outpatients (34 to 74 years old, 62% females) staged according to the Los Andes classification were enrolled. During a follow-up of (mean ± SD) 84.2 ± 39.0 months, 9 subjects developed AF (incidence: 3.3 ± 1.0%/year), 5 had nonfatal stroke (incidence: 1.3 ± 1.0%/year), and nine died (mortality rate: 2.3 ± 0.8%/year). The progression rate of left ventricular mass and left ventricular ejection fraction was significantly greater in subjects who experienced AF (16.4 ± 20.0 g/year and -8.6 ± 7.6%/year, respectively) than in those who did not (8.2 ± 8.4 g/year; P = 0.03, and -3.0 ± 2.5%/year; P = 0.04, respectively). In univariate analysis, left atrial diameter ≥3.2 cm (P = 0.002), pulmonary arterial hypertension (P = 0.035), frequent premature supraventricular and ventricular contraction counts/ 24 h (P = 0.005 and P = 0.007, respectively), ventricular couplets/24 h (P = 0.002), and ventricular tachycardia (P = 0.004) were long-term predictors of AF. P-wave signal-averaged ECG revealed a limited long-term predictive value for AF. In chronic Chagas' disease, large left atrial diameter, pulmonary arterial hypertension, frequent supraventricular and ventricular premature beats, and ventricular tachycardia are long-term predictors of AF. The rate of left ventricular mass enlargement and systolic function deterioration impact AF incidence in this population.

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Section: Discussionsupporting

confidence: 48%

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Benchimol-Barbosa

Barbosa-Filho

2009

Braz J Med Biol Res

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“…In the research that included 299 patients with normal and 67 patients with reduced left ventricular ejection fraction (EF) ≤50% and AF, longitudinal echocardiographic study was conducted [114]. At 6 months after the catheter ablation of AF, among the patients with myocardial dysfunction significant recovery of EF from 42% before to 56% after the procedure was reported.…”

Section: Progression Of Afmentioning

confidence: 99%

Catheter Ablation of Lone Atrial Fibrillation

Mujović

Marinković²,

Potpara³

et al. 2014

CPD

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Atrial fibrillation is the most common sustained arrhythmia in clinical practice, associated with increased mortality, risk of stroke and heart failure, as well as the reduction of the quality of life. Atrial fibrillation may be encountered in young otherwise healthy individuals, due to the isolated electrophysiological disorder limited mostly to the pulmonary veins and posterior left atrial wall, or associated with the presence of advanced underlying heart disease and numerous cardiac and non-cardiac comorbidities with significant structural remodeling of the atrial myocardium. Due to limited efficacy and serious side effects of antiarrhythmic drugs, catheter ablation of atrial fibrillation, based on the pulmonary vein isolation for paroxysmal atrial fibrillation and adjunctive substrate modification for persistent atrial fibrillation, has emerged as an attractive and promissing alternative therapeutic option for selected patients with atrial fibrillation. In this review article, we discuss the electrophysiological left atrial abnormalities underlying lone atrial fibrillation and the role of pulmonary veins in pathophysiology of arrhythmia, and we summarize results of the studies on the long term outcome of catheter ablation of atrial fibrillation, as well as the studies on comparison of antiarrhythmic drugs with catheter ablation for treatment of atrial fibrillation. In addition, we present available data that provide better understanding of mechanisms, diagnosis, prevention and treatment of specific procedure-related complications and discuss current periprocedural anticoagulation strategies and their impact on the thromboembolic risk reduction.

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“…The mean LVEF improved significantly in these patients following ablation, the improvement being more marked in those who achieved successful AF control (Figure 1). Of note, the degree of AF control in these patients was similar to that in patients with normal LV function, but they required more procedures (60). (65,66).…”

Section: Diagnosis and Managementmentioning

confidence: 90%

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

Gupta¹,

Figueredo²

2014

International Journal of Cardiology

109

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Reversal of Left Ventricular Dysfunction Following Ablation of Atrial Fibrillation

Cited by 241 publications

References 36 publications

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Catheter Ablation of Lone Atrial Fibrillation

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

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