title: Comparison of left atrial volumes and function by real-time three-dimensional echocardiography in patients having catheter ablation for atrial fibrillation with persistence of sinus rhythm versus recurrent atrial fibrillation three months later.
abstract: Real-time 3-dimensional echocardiography (RT3DE) can provide a unique combination of accurate left atrial (LA) volume quantification and rapid, automatic assessment of LA function. The aim of the study was to evaluate the changes in LA volumes and function in patients with atrial fibrillation (AF) undergoing radiofrequency catheter ablation (RFCA) using RT3DE; 57 consecutive patients referred for RFCA were studied. Paroxysmal AF was present in 43 patients (75%) and persistent AF in 14 (25%). After a mean follow-up of 7.9 +/- 2.7 months, patients were divided into 2 groups: successful RFCA (SR group) and recurrence of AF (AF group). RT3DE was performed before, within 3 days, and 3 months after RFCA to assess LA volumes (maximum, minimum, and preA) and LA functions (passive, active, and reservoir). A total of 38 patients (67%) had successful RFCA (SR group). Immediately after RFCA, no significant changes in LA volumes and function were observed. After 3 months, a significant reduction in LA volumes (maximum: 26 +/- 8 to 23 +/- 7 ml/m(2), p <0.01) was noted only in the SR group, with a significant improvement in LA active (22 +/- 8% to 33 +/- 9%, p <0.01) and reservoir functions (116 +/- 45% to 152 +/- 54%, p <0.01). Conversely, the AF group showed a trend towards a deterioration of LA volumes and function. In conclusion, in patients who maintain sinus rhythm after RFCA, a significant reverse remodeling and functional improvement of the left atrium is observed using RT3DE.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Laurens F
authors.initials: LF
authors.lastname: Tops
authors.forename: Eduard R
authors.initials: ER
authors.lastname: Holman
authors.forename: Nico R
authors.initials: NR
authors.lastname: Van de Veire
authors.forename: Katja
authors.initials: K
authors.lastname: Zeppenfeld
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D016279:Atrial Function, Left; D017115:Catheter Ablation; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018709:Statistics, Nonparametric; D016896:Treatment Outcome