title: Early and late cardiac ventricular reverse remodeling after catheter ablation for lone paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  We sought to explore ventricular function in patients with lone paroxysmal atrial fibrillation (AF) and determine the mid- and long-term impact of pulmonary vein isolation on cardiac remodeling.
  
  
  BACKGROUND
  The relationship between tachyarrhythmia and ventricular dysfunction is still a matter of debate. Tachycardia-induced cardiomyopathy is defined as reversible myocardial dysfunction following treatment for tachyarrhythmia.
  
  
  METHODS
  We prospectively studied 31 patients (56.4 ± 10 years) presenting with paroxysmal-AF who were treated successfully by catheter ablation and 15 age-matched controls. Left and right ventricular functions were assessed by echocardiography at baseline and at 3-month and 1-year follow-up.
  
  
  RESULTS
  In AF-patients, LV-function was slightly lower at baseline than controls (LV-ejection fraction was 60% versus 64%; P = 0.06). More impressive, systolic peak velocity on Doppler tissue imaging was 9 cm/s in AF patients (versus 12 cm/s; P = 0.0004). LV global longitudinal strain was also significantly different between the two groups (patients: -16% versus controls: -19%; P = 0.005). At 1-year follow-up, most functional parameters significantly improved in the AF-patients and no longer differed from the controls. Right ventricular (RV) function was also depressed in AF patients at baseline. At 1-year follow-up, tissue Doppler showed improvement in RV-S' (+27%, P = 0.007) and RV peak systolic strain (+36%, P<0.0001) and became comparable to controls.
  
  
  CONCLUSIONS
  We demonstrate that some degree of arrhythmic cardiomyopathy exists in patients presenting with lone paroxysmal-AF. Catheter ablation improved RV and LV functions. Longitudinal function is the most sensitive component of ventricular systole to monitor when looking for this cardiac reverse remodeling.
authors.affiliation: U, Inserm, Rennes, France.
authors.forename: R
authors.initials: R
authors.lastname: Ollivier
authors.forename: E
authors.initials: E
authors.lastname: Donal
authors.forename: D
authors.initials: D
authors.lastname: Veillard
authors.forename: D
authors.initials: D
authors.lastname: Pavin
authors.forename: S
authors.initials: S
authors.lastname: Hamonic
authors.forename: J-C
authors.initials: JC
authors.lastname: Daubert
authors.forename: P
authors.initials: P
authors.lastname: Mabo
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016278:Ventricular Function, Right