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Journal of cardiovascular electrophysiology v.28 no.2, 2017년, pp.167 - 176   SCI SCIE
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Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1‐Year Follow‐Up Multislice Computed Tomography Study

KIM, JIN‐SEOK (Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea ) ; IM, SUNG IL (Division of Cardiology, Kosin University Gospel Hospital, College of Medicine, Kosin University, Busan, Korea ) ; SHIN, SEUNG YONG (Division of Cardiology, Heart Research Institute, College of Medicine, Chung‐Ang University, Seoul, Korea ) ; KANG, JUN HYUK (Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea ) ; NA, JIN OH (Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea ) ; CHOI, CHEOL UNG (Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea ) ; KIM, SEONG HWAN (Division of Cardi ) ; KIM, EUNG JU ; RHA, SEUNG‐WOON ; PARK, CHANG GYU ; SEO, HONG SEOG ; OH, DONG JOO ; HWANG, CHUN ; KIM, YOUNG‐HOON ; YONG, HWAN SEOK ; LIM, HONG EUY ;
  • 초록  

    LA Functional Remodeling After AF Ablation Background Functional remodeling of left atrium (LA) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has not been fully elucidated. This study aimed to determine the impact of RFCA on LA transport function in patients who maintained sinus rhythm (SR) after AF ablation. Methods and Results A total of 96 patients (paroxysmal AF [PAF] = 52) who maintained SR during 1 year after AF ablation were enrolled. Multislice computed tomography was performed to determine LA volume (LAV) and LA emptying fraction (LAEF) at pre‐RFCA and 1‐year post‐RFCA. Creatine kinase‐MB (CK‐MB) and troponin‐T levels were analyzed 1‐day post‐RFCA. At 1‐year post‐RFCA, mean LAV and LAEF decreased in overall patients. Based on LAEF change (ΔLAEF) cutoff of 5.0%, LAEF reduced in 41 patients (worsened group) and improved or showed no change in 55 patients (preserved group). Compared with preserved group, worsened group had a higher proportion of PAF, higher levels of CK‐MB and troponin‐T, and additional LA ablation. ΔLAEF was inversely correlated with CK‐MB and troponin‐T levels. Subgroup analysis showed that LAEF significantly decreased in PAF patients who underwent additional LA ablation. Multivariate analysis revealed that high baseline LAEF and additional LA ablation were independent predictors for worsened LAEF. Conclusions Although SR was maintained for 1 year after AF ablation, LAEF as well as LAV decreased. The extent of LAEF deterioration was significantly associated with the amount of iatrogenic myocardial damage. Our data indicate that extensive atrial ablation may lead to LA functional deterioration, especially in patients with PAF.


  • 주제어

    atrial fibrillation .   atrial function .   catheter ablation .   computed tomography .   left atrium.  

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