Effect of radiofrequency catheter ablation for atrial fibrillation on left atrial cavity size.

Left atrial (LA) remodeling is associated with atrial fibrillation (AF). Radiofrequency catheter ablation offers a good treatment option for AF, with reasonable long-term results. The purpose of the present study was to assess whether LA reverse remodeling occurs after successful catheter ablation. Fifty-seven consecutive patients (45 men; age 53 +/- 8 years) with symptomatic drug-refractory AF were treated with radiofrequency catheter ablation. The patients were divided into 2 groups on the basis of AF recurrence as determined by Holter monitoring and 12-lead electrocardiographic findings at 6 weeks and 3 months of follow-up (sinus rhythm [SR] group, no recurrence; AF group, AF recurrence). At baseline and 3 months of follow-up, 2-dimensional echocardiography was performed to assess LA size and dimensions. Furthermore, LA volumes were measured at end-systole and end-diastole. After 3 months, 39 of 57 patients (68%) maintained SR. At 3 months of follow-up, the LA anteroposterior diameter showed a significant reduction in the SR group (4.5+/- 0.3 vs 4.2 +/- 0.2 cm, p <0.01), and an additional increase was observed in the AF group (4.5+/- 0.3 vs 4.8 +/- 0.3 cm, p <0.05). Furthermore, the LA end-systolic and end-diastolic volumes decreased significantly in the SR group from baseline to follow-up (59 +/- 12 vs 50 +/- 11 ml, p <0.01, and 37 +/- 9 vs 31 +/- 7 ml, p <0.01, respectively). However, a tendency toward an increase in LA volumes was observed in the AF group. In conclusion, the results of this study have demonstrated that LA reverse remodeling occurs after successful radiofrequency catheter ablation for AF.