title: Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging.
abstract: OBJECTIVE
  Beneficial effects of atrial fibrillation (AF) ablation have been demonstrated in patients with congestive heart failure (CHF) and significantly impaired left ventricular ejection fraction (LVEF). However, the impact of pulmonary vein isolation (PVI) on cardiac function in patients with paroxysmal AF and impaired LVEF remains under discussion. This study aimed to evaluate the impact of PVI for paroxysmal AF on cardiac function in patients with impaired LVEF using cardiac magnetic resonance imaging (CMRI).
  
  
  RESULTS
  A total number of 70 patients with paroxysmal AF and episodes < or = 24 h were scanned on a 1.5-T-CMRI before and 6 months after PVI during sinus rhythm. End-diastolic volume, end-systolic volume, and LVEF were determined by epicardial and endocardial measurements. Patients were categorized into two groups regarding cardiac function as assessed by CMRI: group 1 patients (n = 18) with an LVEF < 50% and patients with an LVEF > 50% (group 2, n = 52). Group 1 patients demonstrated a significant lower success rate than patients of group 2 after a follow-up of 152 +/- 40 days (50 vs. 73%, P < 0.05). Cardiac magnetic resonance imaging in group 1 patients demonstrated a significant improvement in cardiac function after AF ablation (41 +/- 6 vs. 51 +/- 12%, P = 0.004), whereas group 2 patients did not show significant differences (60 +/- 6 vs. 59 +/- 9%, P = 0.22) after a 6 months follow-up.
  
  
  CONCLUSIONS
  Pulmonary vein isolation improves cardiac function in patients with paroxysmal AF and impaired LVEF. These data suggest that an impaired LV function can be partially attributed to AF with short-lasting paroxysms.
authors.affiliation: Department of Cardiology, University Hospital Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany. lutomsky@uke.uni-hamburg.de
authors.forename: Boris A
authors.initials: BA
authors.lastname: Lutomsky
authors.forename: Thomas
authors.initials: T
authors.lastname: Rostock
authors.forename: Andreas
authors.initials: A
authors.lastname: Koops
authors.forename: Daniel
authors.initials: D
authors.lastname: Steven
authors.forename: Kai
authors.initials: K
authors.lastname: Müllerleile
authors.forename: Helge
authors.initials: H
authors.lastname: Servatius
authors.forename: Imke
authors.initials: I
authors.lastname: Drewitz
authors.forename: Denis
authors.initials: D
authors.lastname: Ueberschär
authors.forename: Thorsten
authors.initials: T
authors.lastname: Plagemann
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Ventura
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*