TITLE:
Improvement of left ventricular function in patients with persistent atrial tachyarrhythmia induced cardiomyopathy undergoing radiofrequency ablation
AUTHORS:
Xiangmin Shi, Zhaoliang Shan, Hongyang Guo, Yutang Wang
KEYWORDS:
Tachyarrhythmia-Induced Cardiomyopathy; Radiofrequency Ablation; Left Ventricular Dysfunction; Sinus Rhythm
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.9,
December
17,
2013
ABSTRACT: Purpose:
To investigate the alteration of left ventricular function in subjects with
persistent atrial tachyarrhythmia induced cardiomyopathy (TIC) undergoing
radiofrequency ablation, and to study the pathogenesis and effective treatment
of TIC. Methods: A total of 25 cases
with persistent atrial tachyarrhythmia and impaired left ventricular systolic
function were studied (16 men and 9 women, aged 53.3 ± 15.2 years), and all subjects underwent
electrophysiological study and radiofrequency ablation of atrial tachyarrhythmia
under the guidance of CARTO system during 2006.9-2011.8. Indexes related to
cardiac function, including left ventricular end diastolic diameter (LVEDD),
left ventricular ejection fraction (LVEF), New York Heart Association
functional classification (NYHA class), 6 minutes walking test (6MWT), N-terminal
pro-brain natriuretic peptide (BNP) and 24 hours average heart rate (AHR), were
analyzed at the time point of 7 days, 3 and 6 months after the procedure as
well as 1 day before ablation. Results:
No refractory atrial arrhythmia recurred in all cases after ablation, compared
with LVEDD (51.7 ± 4.5 mm), LVEF (39.0% ± 4.3%), number of patients with NYHA
class IV and III (n = 17), 6MWT (212 ± 56 m), BNP (3622 ± 1860 ng/L) and AHR
(112.5 ± 23.2 bpm) before ablation, the index of LVEDD (45.2 ± 3.3 mm; 41.7 ± 2.5
mm; 40.5 ± 3.1 m), BNP (2429 ± 1355 ng/L; 1530 ± 866 ng/L; 1300 ± 520 ng/L),
total number of patients of NYHA class IV and III (n = 11; 3; 2) and AHR (73.3 ±
15.3 bpm; 68.7 ± 13.5 bpm; 66.3 ± 13.6 bpm) significantly decreased (P
47 m; 305 ±
37 m; 313 ± 41 m) greatly increased (P ）in 7 days, 3 and 6 months
after ablation respectively. There was a statistical
difference between 7 days and 3 or 6 months after ablation in
above-mentioned indexes (P P > 0.05), no significant
difference existed between 3 and 6 months in all indexes (P > 0.05). Conclusion:
long-lasting atrial arrhythmia with rapid ventricular response could impair
left ventricle function, which could be reversed within weeks after successful
ablation and restoration of sinus rhythm.