The Effect of Ablation for Paroxysmal Atrial Fibrillation on Left Atrial Volume and Function: A One-Year Follow-Up Study

ABSTRACT

PURPOSE: The effect of radiofrequency catheter ablation (RFCA) on left atrial (LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) has not been extensively studied. The aim of this study was to evaluate the long-term impact of RFCA on LA volume and function in patients with PAF. MATERIALS AND METHODS: A total of 90 patients with drug-refractory PAF who had sinus rhythm on the initial echocardiogram were examined at baseline, 3 months and 1 year after ablation. We measured LA volume index, LA ejection fraction (LAEF; maximal-minimal LA volume/maximal LA volume), and LA active emptying fraction (LAAEF; mid-diastolic-minimal LA volume/mid-diastolic LA volume). RESULTS: After 12+/-1 months, 78 patients returned, and 61 patients (78%) had sinus rhythm. After 3 months, the LA maximal volume indices decreased (from 33+/-13 to 28+/-12 mL/m2; p<0.001). But, LAEF and LAAEF also decreased (from 48+/-13 to 39+/-12; p<0.001, from 27+/-13 to 19+/-11; p<0.001). After 1 year, LA volumes, LAEF, and LAAEF remained similar at 3 months. In patients without atrial fibrillation (AF) recurrence, LAEF and LAAEF decreased after 3 months (from 50+/-12 to 40+/-11; p<0.001, from 29+/-13 to 22+/-11; p<0.001) and did not change after 1 year. However, in patients with AF recurrence, those who did not have decreased levels after 3 months had significantly decreased after 1 year (from 43+/-14 to 34+/-11; p=0.026, from 22+/-12 to 15+/-10; p=0.012). CONCLUSION: Successful RFCA of PAF decreased LA volume and function at 3 months. At one year, LA volume and function was remained unchanged in successfully ablated patients whereas LA function in patients with AF recurrence worsened.