Sequential Evaluation of Left Ventricular Systolic and Diastolic Function After Radiofrequency Catheter Ablation

Abstract

SUMMARYRadiofrequency (RF) catheter ablation has become standard therapy for many types of arrhythmias. RF energy may cause deterioration in left ventricular function by damaging the myocardium. The aim of the present study was to assess the changes in left ventricular function after catheter ablation using various echocardiographic parameters.Forty patients (22 women), aged 37 ± 14 years (range, 15-76 years), underwent catheter ablation for various tachycardias. Routine echocardiogaphic examination was done in all patients. Left ventricular systolic function was evaluated by the modified Simpson method and tissue Doppler. With regard to left ventricular diastolic function parameters, diastolic early (E) and late (A) transmitral filling velocities, deceleration time (DT), isovolumetric relaxation time (IVRT), and tissue Doppler parameters were assessed. All ventricular function parameters were assessed before, and 1 hour, 1 day, and 1 month after the catheter ablation procedure. To avoid any influence of heart rate on diastolic function parameters, the E/A ratio, DT, and IVRT were adjusted to heart rate (cE/A, cDT, cIVRT).No changes in left ventricular systolic function after the ablation were observed. After the ablation procedure (1 hour, 1 day, and 1 month) the cE/A ratio decreased from 1.42 ± 0.43 to 1.19 ± 0.40, 1.18 ± 0.40, and 1.30 ± 0.33 (P = 0.009), respectively. cDT increased from 210 ± 54 to 272 ± 64, 255 ± 60, 240 ± 64 (P = 0.001), respectively. Likewise cIVRT increased from 113 ± 22 to 133 ± 54, 123 ± 27, 117 ± 19 (P = 0.007), respectively. Significant changes were also observed concerning tissue Doppler parameters in assessing diastolic function.Although no significant changes were observed in systolic function after RF ablation, this procedure may have some detrimental effects on ventricular diastolic function parameters. (Jpn Heart J 2004; 45: 429-440)

Effect of Radiofrequency Catheter Ablation on Doppler Echocardiographic Parameters in Patients With Wolff-Parkinson-White Syndrome

“…33,34) In this study, we found significant increases in A velocity, its VTI, and DFT, and a decrease in E/A after abolishing the accessory pathway. There were no changes in E velocity, its VTI, DT, and IVRT.…”

“…However, their study population had various types of tachyarrhythmias. 34) Previous investigations with sequential AV pacemakers have demonstrated that a short AV delay is associated with a reduced A wave velocity and atrial filling fraction. It has been postulated that because of interruption of active atrial transport by ventricular systole, atrial emptying is incomplete resulting in an increase in residual left atrial volume and pressure.…”

The use of echocardiography in Wolff–Parkinson–White syndrome

“…In the past decades, with technical improvement, echocardiography has emerged as an investigational tool to predict accessory pathway location in WPW syndrome with satisfactory accuracy [5][6][7][8][9]. In addition, echocardiography has been used to guide the ablation procedure [10][11][12], and to provide crucial information about co-existent cardiac abnormalities [6,13], cardiac function [14][15][16][17][18], and procedural complications [19,20]. This review summarizes the current use of echocardiography in WPW syndrome.…”