Emmanouil Charitakis1, Lars OKarlsson1, Carl-Johan Carlhäll2,3, Ioan Liuba1, Anders Hassel Jönsson1, Håkan Walfridsson1, Urban Alehagen4. 1. Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 2. Department of Clinical physiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 3. Division of Cardiovascular Medicine and CMIV, Linköping University, Linköping, Sweden. 4. Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden.
Abstract
BACKGROUND: Radiofrequency ablation (RFA)is an important treatment option for patients with atrial fibrillation (AF). During RFA, a significant amount of energy is delivered into the left atrium (LA), resulting in considerable LA-injury. The impact of this damage on mechanical and endocrine LA-function, however, is often disregarded.We therefore aimed to evaluate the endocrine- and mechanical function of the heart 4-months after RFA of AF. METHODS: In total 189 patients eligible for RFA of AF were studied. The levels of the N-terminal pro-B-natriuretic peptide (NT-proBNP) and the mid-regional fragment of the N-terminal pro-atrial natriuretic peptide (MR-proANP)were measured. The maximum LAvolume (LAVmax),the LAejection fraction (LAEF) and the LA peak longitudinal strain (PALS), were measured usingtransthoracic echocardiography. The measurements were performed before and 4-months after the intervention. RESULTS: 87 patients had a recurrence during a mean follow-up of 143±36 days.NT-proBNPand MR-proANPdecreased significantly at follow-up. This reduction was greater in patients who did not suffer any recurrence after RFA.The LAVmax decreased significantly, whereasthe PALS only improved in patients who did not suffer from any recurrence. On the other hand, LAEF did not change significantly after RFA of AF. CONCLUSIONS: Despite extensiveablation during RFA of AF, the endocrine function of the heart improved 4-months after the index procedure. Patients with no arrhythmia recurrence showed a more pronounced improvement in their endocrinal function. Mechanically, the LAVmax was reduced, and the LA strain improved significantly.
BACKGROUND: Radiofrequency ablation (RFA)is an important treatment option for patients with atrial fibrillation (AF). During RFA, a significant amount of energy is delivered into the left atrium (LA), resulting in considerable LA-injury. The impact of this damage on mechanical and endocrine LA-function, however, is often disregarded.We therefore aimed to evaluate the endocrine- and mechanical function of the heart 4-months after RFA of AF. METHODS: In total 189 patients eligible for RFA of AF were studied. The levels of the N-terminal pro-B-natriuretic peptide (NT-proBNP) and the mid-regional fragment of the N-terminal pro-atrial natriuretic peptide (MR-proANP)were measured. The maximum LAvolume (LAVmax),the LAejection fraction (LAEF) and the LA peak longitudinal strain (PALS), were measured usingtransthoracic echocardiography. The measurements were performed before and 4-months after the intervention. RESULTS: 87 patients had a recurrence during a mean follow-up of 143±36 days.NT-proBNPand MR-proANPdecreased significantly at follow-up. This reduction was greater in patients who did not suffer any recurrence after RFA.The LAVmax decreased significantly, whereasthe PALS only improved in patients who did not suffer from any recurrence. On the other hand, LAEF did not change significantly after RFA of AF. CONCLUSIONS: Despite extensiveablation during RFA of AF, the endocrine function of the heart improved 4-months after the index procedure. Patients with no arrhythmia recurrence showed a more pronounced improvement in their endocrinal function. Mechanically, the LAVmax was reduced, and the LA strain improved significantly.
Entities:
Keywords:
Atrial fibrillation; Left Atrial Ejection Fraction; Left Atrial Strain; Natriuretic Peptides; Radiofrequency Ablation
Authors: Stephan von Haehling; Gerasimos S Filippatos; Jana Papassotiriou; Mariantonietta Cicoira; Ewa A Jankowska; Wolfram Doehner; Piotr Rozentryt; Corrado Vassanelli; Joachim Struck; Waldemar Banasiak; Piotr Ponikowski; Dimitrios Kremastinos; Andreas Bergmann; Nils G Morgenthaler; Stefan D Anker Journal: Eur J Heart Fail Date: 2010-03-09 Impact factor: 15.534