Chronic atrial fibrillation ablation impact on endocrine and mechanical cardiac functions.
OBJECTIVE
Assess the impact of persistent/permanent atrial fibrillation (AF) ablation on endocrine and mechanical cardiac functions.


RESULTS
In all, 43 patients (40 males, 53 +/- 12 years) undergoing persistent/permanent AF ablation had atrial (ANP) and brain natriuretic peptide (BNP) measurements before day 1, 3, and 3 months after ablation. In the same period of time transthoracic echocardiography was performed. With a mean radiofrequency delivery of 98 +/- 29 min, sinus rhythm (SR) was restored in 30 patients (70%) without DC shock. ANP decreased significantly (P < 0.001) with restoration of SR and then increased until day 3 post ablation without reaching the level observed during AF. At 3 months, ANP was significantly lower than day 3 reaching normal value in 28 (65%) patients and being <7 pg/mL in 4 (9%). The BNP followed the same trend with normal BNP level in 23 (53%) patients at 3 months. Identifiable atrial filling waves on the pulsed Doppler transmitral recordings performed between day 2 and day 4 after the procedure were seen in 18 patients (42%). At 3 months, 39 (95%) of the patients with SR during echocardiography had a significant A wave.


CONCLUSIONS
SR following persistent/permanent AF ablation is associated with a dramatic decrease in natriuretic peptides. At 3 months, despite relatively extensive atrial ablation, endocrine and mechanical cardiac functions are significantly improved.
Sacher
Frédéric
F
Service de Rythmologie, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux/Université Bordeaux II, Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr <frederic.sacher@chu-bordeaux.fr>
Corcuff
Jean-Benoît
JB
Schraub
Philippe
P
Le Bouffos
Valérie
V
Georges
Agnès
A
Jones
Samuel O
SO
Lafitte
Stéphane
S
Bordachar
Pierre
P
Hocini
Mélèze
M
Clémenty
Jacques
J
Haissaguerre
Michel
M
Bordenave
Laurence
L
Roudaut
Raymond
R
Jaïs
Pierre
P
D001281:Atrial Fibrillation / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D016275:Atrial Function; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D017115:Catheter Ablation; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D019210:Troponin I / Q000378:metabolism
D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor