Alteration of right ventricular function after catheter ablation in patients with persistent atrial fibrillation and concomitant heart failure with preserved ejection fraction

ABSTRACT

Objective To investigate the alteration of right ventricular function after catheter ablation in patients with persistent atrial fibrillation (PAF) and concomitant heart failure with preserved ejection fraction (HFpEF). Methods The prospective observational study was performed in patients with HFpEF-PAF and undergoing first-time radiofrequency ablation procedures in the First Affiliated Hospital of Nanjing University between May to December 2019. Right ventricular functional parameters were measured before and 5 days, 1, 3, 6 and 12 months after the ablation by transthoracic echocardiography, respectively, including the right ventricular fractional area change (RVFAC). tricuspid annular plane systolic excursion(TAPSE), tricuspid annular diameter (TVAD). tricuspid annular peak systolic speed(TDI-S) and longitudinal strain of right ventricular free wall (RVFLS). Meanwhile, routine ECG and Holler recordings were performed at each follow-up time point. Results In this study, atrial fibrillation (AF) recurrence occurred in 4 patients at the 3rd month after ablation, and 7 patients failed to follow up due to the Covid-19. Finally, 19 patients were followed up for the evaluation of cardiac function after catheter ablation. Compared with pre-ablation, right ventricular structural and functional paramters (RVFAC, TAPSE, TVAD, TDI-S. RVFLS) improved significantly at all stages of follow-up(all P <0.05). Patients with atrial fibrillation recurrence had lower RVFLS and TDI-S at the baseline(P =0.039, P =0.019). Conclusions Right ventricular function could improve in HFpEF-PAF patients who maintain sinus rhythm after radiofrequency ablation. © 2022 ChinJUltrasonogr. All rights reserved.