title: Prevalence and predictors of worsened left ventricular diastolic dysfunction after catheter ablation of atrial fibrillation.
abstract: BACKGROUND
  The interactions between atrial fibrillation (AF) and left ventricular diastolic dysfunction (LVDD) are complex and not well defined. Despite the high prevalence of LVDD in the AF population, therapies for LVDD remain limited. Previous studies have suggested that restoration of sinus rhythm with catheter ablation has a positive effect on LVDD, but the prevalence and predictors for worsened LVDD are unknown.
  
  
  METHODS
  70 consecutive patients included in prospective AF catheter ablation registry (61±10 years, 66% male) with paroxysmal (n=40) or persistent AF (n=30) were examined by transthoracic echocardiography, before and 12 months after ablation. LVDD was classified according to current guidelines. Rhythm outcome of the ablation was verified by serial 7-day Holter ECG.
  
  
  RESULTS
  LVDD was present in 27 patients (38%) at baseline and in 33 patients (47%) at 12 months follow-up (p=.327). An improvement of LVDD was observed in 13 patients (19%), an aggravation was found in 19 (27%), while it was unchanged in the remaining 38 patients (54%). In uni- and multivariable regression analysis, total ablation time (OR 1.611 per 10 min ablation time, 95% CI 1.088-2.386, p=.017) was associated with LVDD progression, while neither baseline characteristics nor rhythm during follow-up influenced LVDD alterations. There was no association between echocardiographic deterioration and symptoms.
  
  
  CONCLUSIONS
  Catheter ablation of AF can worsen LVDD in a substantial proportion of patients with more aggressive ablation leading to aggravation of LVDD. While there are no apparent negative short-term effects, long-term consequences need to be determined.
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany. Electronic address: jedrzejkosiuk@hotmail.com.
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Kosiuk
authors.forename: Piotr
authors.initials: P
authors.lastname: Buchta
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaspar
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D017115:Catheter Ablation / Q000639:trends*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Atrial fibrillation; Catheter ablation; Diastolic dysfunction; Echocardiography