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Original Articles

Long-Term Improvement in Left Ventricular Strain After Successful Catheter Ablation for Atrial Fibrillation in Patients With Preserved Left Ventricular Systolic Function

Laurens F. Tops, MD; Dennis W. Den Uijl, MD; Victoria Delgado, MD; Nina Ajmone Marsan, MD; Katja Zeppenfeld, MD, PhD; Eduard Holman, MD, PhD; Ernst E. van der Wall, MD, PhD; Martin J. Schalij, MD, PhD and Jeroen J. Bax, MD, PhD

From the Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Correspondence to Jeroen J. Bax, MD, Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. E-mail j.j.bax{at}lumc.nl

Received November 25, 2008; accepted April 7, 2009.

Background— The effect of successful catheter ablation on left ventricular (LV) strain in patients with preserved LV systolic function is unknown. The aim of the present study was to assess the long-term effects of catheter ablation for atrial fibrillation (AF) on LV strain and strain rate in patients with preserved LV ejection fraction.

Methods and Results— In 78 patients undergoing catheter ablation for AF, speckle tracking strain imaging was performed to assess LV strain in 3 directions (radial, circumferential, and longitudinal) at baseline and after 12-month follow-up. The study population was divided into 2 groups, according to the maintenance of sinus rhythm (SR) during follow-up. After 13.8±4.7 months of follow-up, 54 patients (69%) were in SR (SR group), whereas 24 patients (31%) had recurrence of AF (AF group). No significant changes in LV ejection fraction from baseline to follow-up were noted (60±7% versus 59±7%, P=NS). Circumferential strain improved significantly in the SR group (–18.3±3.2% versus –20.4±3.8%, P<0.001), whereas it remained unchanged in the AF group (–18.9±3.5% versus –17.9±3.1%, P=NS). In the SR group, significant improvements in LV longitudinal strain and strain rate were noted, whereas in the AF group, LV longitudinal strain and strain rate deteriorated significantly at long-term follow-up.

Conclusions— After successful catheter ablation, LV circumferential and longitudinal strain and strain rate improve significantly in patients who maintain SR. In contrast, a decrease in LV longitudinal strain and strain rate is observed in patients with recurrence of AF.

Key Words: atrial fibrillation • catheter ablation • left ventricular function • strain echocardiography

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CLINICAL PERSPECTIVE

The online-only Data Supplement is available at http://circep.ahajournals.org/cgi/content/full/CIRCEP.108.838748/DC1.