Reverse Remodeling of the Left Cardiac Chambers After Catheter Ablation After 1 Year in a Series of Patients With Isolated Atrial Fibrillation

Réant, Patricia; Lafitte, Stéphane; Jaı̈s, Pierre; Serri, Karim; Weerasooriya, Rukshen; Hocini, Mélèze; Pillois, Xavier; Clémenty, Jacques; Haı̈ssaguerre, Michel; Roudaut, R.

doi:10.1161/circulationaha.104.523928

Cited by 232 publications

(228 citation statements)

References 34 publications

(24 reference statements)

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“…Evidence of negative remodeling in AF has been supplied (28), as well as proof of its iterative reversibility (29).…”

Section: Pathophysiologic Considerationsmentioning

confidence: 99%

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Range¹,

Paul²,

Schäfers³

et al. 2009

J Nucl Med

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Recent studies have shown that idiopathic atrial fibrillation (AF) is associated with diminished myocardial perfusion and perfusion reserve, which are also impaired in various forms of cardiomyopathies. In many cases, AF develops during progression of dilated cardiomyopathy (DCM) and may aggravate heart failure. This study compared myocardial perfusion between patients with nonischemic DCM with and without AF. Methods: Twelve men (age 6 SD, 55 6 12 y) who had DCM and persistent AF were compared with a group of 18 men (mean age, 43 6 15 y, P 5 not statistically significant) who had DCM and sinus rhythm and with 22 healthy controls (mean age, 47 6 13 y, P 5 not statistically significant). Myocardial blood flow (MBF) was noninvasively quantified at rest and during adenosine infusion using PET and radioactive-labeled water (H 2 15 O PET). Results: Compared with controls, DCM patients without AF showed impaired hyperemic perfusion (2.52 6 1.29 vs. 3.57 6 0.88 mL/min/mL, P 5 0.014) and perfusion reserve (2.10 6 1.01 vs. 3.37 6 0.97, P 5 0.003). However, compared with DCM patients without AF, DCM patients with AF showed an additional impairment in resting perfusion (0.82 6 0.31 mL/min/mL, P 5 0.010) and hyperemic perfusion (1.32 6 0.93 mL/min/mL, P 5 0.022), and compared with controls, DCM patients with AF showed a further diminishment of perfusion reserve (1.68 6 0.94 vs. 3.37 6 0.97, P , 0.001) accompanied by the highest coronary vascular resistance of all groups. Conclusion: Compared with patients with sinus rhythm, patients with AF have significantly reduced myocardial perfusion reserve and increased coronary resistance in nonischemic DCM. Further studies on the underlying pathomechanisms are warranted.

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“…Evidence of negative remodeling in AF has been supplied (28), as well as proof of its iterative reversibility (29).…”

Section: Pathophysiologic Considerationsmentioning

confidence: 99%

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Range¹,

Paul²,

Schäfers³

et al. 2009

J Nucl Med

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“…AF remodeling is not a permanent event, since even in persistent AF, the remodeling is reversible, a fact that is of paramount importance in the management of patients with this form of AF. Indeed, conversion of AF to SR, either by electrical or pharmacologic means or after radiofrequency ablation, reduces atrial size [25,26], and improves atrial contractility [27−29].…”

Section: Does Maintenance Of Sr During 3-month Treatment With Amiodarmentioning

confidence: 99%

Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

et al. 2014

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“…Median mitral A wave velocity was 0.76 m/s and mitral E wave velocity 0.78 m/s. Several studies described structural reverse remodelling of the LA after pulmonary vein isolation as treatment of AF [3,4,[11][12][13][14][15]. Muller et al [16] documented a reverse remodelling in both atria after AF ablation.…”

Section: Follow-up Studymentioning

confidence: 99%

Echocardiographic Biatrial Remodelling and Diastolic Function Assessment in Long-Term Follow-Up after Typical Atrial Flutter Ablation

Cabanas‐Grandío¹

2014

J Cardiovasc Med Cardiol

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Background: A reverse left atrial (LA) remodelling after atrial fibrillation (AF) ablation has been reported and a relationship between diastolic function and AF is well known. However, there is little information about atrial remodelling and diastolic function after cavotricuspid isthmus (CTI) ablation. We aimed to evaluate long-term biatrial remodelling and diastolic function in patients undergoing CTI ablation. Methods:A transthoracic echocardiography was performed at baseline and at longterm follow-up (6.3 ± 0.5 years) in a total of 39 patients who underwent AFl ablation. Right atrial end diastolic areas (RAEDA) and end systolic areas (RAESA), right atrial contraction fraction (RACF), mitral A wave velocity, E/A rate and LA diameter were measured. They were compared using the Wilcoxon rank sum test.Results: Mean (SD) age was 64 (10) years, 82% male, 49% hypertension and 44% prior AF episodes. Basal RAEDA and RAESA were higher than at follow-up: median (IQR) of 24.6 cm² (19.8-28.2) vs. 20.0 cm² (16.0-25.0), p = 0.017 and 17.4 cm² (13.0-19.3) vs. 12.0 cm² (9.8-17.0), p = 0.001, respectively. RACF was higher at follow-up: 0.41 (0.35-0.45) vs. 0.31 (0.19-0.37), p = 0.001. Basal mitral A wave velocity was lower than at follow-up: 0.51 (0.4-0.6) vs. 0.78 (0.7-0.9), p =0.001 and E/A rate was higher 1.9 (1.2-3.1) vs. 0.9 (0.7-1.1), p = 0.001. LA diameter at baseline was 44.8 mm (39.3-50.7) vs. 46 mm (41.5-51.5) at follow-up, p <0.001. Conclusion:AFl ablation led to reverse remodelling of the right atrium and improved diastolic dysfunction parameters in the long-term follow-up.limited studies suggest that AFl ablation also favours LA function recovery, as occurs after AF ablation [7]. However, there is no information about right atrial (RA) and LA anatomical remodelling in the long term follow-up after AFl ablation. Our objective was to investigate echocardiographic biatrial remodelling and diastolic function in the long-term follow-up after cavotricuspid isthmus (CTI) ablation. Methods Study populationWe included 39 patients who had undergone typical AFl ablation between January 2003 and May 2005 in which a complete echocardiographic study was performed at baseline (first 6 hours after ablation procedure) and at follow-up (mean ± SD of 6.3 ± 0.5 years) to assess echocardiographic remodelling.All patients included were over 18 years, with at least one episode of documented AFl in the previous 6 months, and demonstrated a CTI-dependent AFl during electrophysiological study, or CTI permeability with an electrocardiogram suggestive of typical AFl, in cases where the procedure was performed in sinus rhythm. IntroductionAtrial fibrillation (AF) is the most common arrhythmia seen in clinical practice and it is well-known that there is a relationship between AF and diastolic function [1]. It is also known that LA function is recovered after cardioversion to sinus rhythm as well as after AF ablation, and a reverse LA remodelling after AF ablation has also been reported [2][3][4][5]. ISSN: 2455-2976Citation: Cabanas...

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Reverse Remodeling of the Left Cardiac Chambers After Catheter Ablation After 1 Year in a Series of Patients With Isolated Atrial Fibrillation

Cited by 232 publications

References 34 publications

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

Echocardiographic Biatrial Remodelling and Diastolic Function Assessment in Long-Term Follow-Up after Typical Atrial Flutter Ablation

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