title: Long-term improvement in left ventricular strain after successful catheter ablation for atrial fibrillation in patients with preserved left ventricular systolic function.
abstract: BACKGROUND
  The effect of successful catheter ablation on left ventricular (LV) strain in patients with preserved LV systolic function is unknown. The aim of the present study was to assess the long-term effects of catheter ablation for atrial fibrillation (AF) on LV strain and strain rate in patients with preserved LV ejection fraction.
  
  
  RESULTS
  In 78 patients undergoing catheter ablation for AF, speckle tracking strain imaging was performed to assess LV strain in 3 directions (radial, circumferential, and longitudinal) at baseline and after 12-month follow-up. The study population was divided into 2 groups, according to the maintenance of sinus rhythm (SR) during follow-up. After 13.8+/-4.7 months of follow-up, 54 patients (69%) were in SR (SR group), whereas 24 patients (31%) had recurrence of AF (AF group). No significant changes in LV ejection fraction from baseline to follow-up were noted (60+/-7% versus 59+/-7%, P=NS). Circumferential strain improved significantly in the SR group (-18.3+/-3.2% versus -20.4+/-3.8%, P<0.001), whereas it remained unchanged in the AF group (-18.9+/-3.5% versus -17.9+/-3.1%, P=NS). In the SR group, significant improvements in LV longitudinal strain and strain rate were noted, whereas in the AF group, LV longitudinal strain and strain rate deteriorated significantly at long-term follow-up.
  
  
  CONCLUSIONS
  After successful catheter ablation, LV circumferential and longitudinal strain and strain rate improve significantly in patients who maintain SR. In contrast, a decrease in LV longitudinal strain and strain rate is observed in patients with recurrence of AF.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Laurens F
authors.initials: LF
authors.lastname: Tops
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Den Uijl
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Katja
authors.initials: K
authors.lastname: Zeppenfeld
authors.forename: Eduard
authors.initials: E
authors.lastname: Holman
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: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012849:Sinoatrial Node / Q000502:physiology; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016277:Ventricular Function, Left