title: Impact of atrial fibrillation-induced tachycardiomyopathy in patients undergoing pulmonary vein isolation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a recognized treatable cause of tachycardiomyopathy (TMP), with class IIb indication for catheter ablation (CA). The aim of this study is to analyze the prevalence, clinical characteristics and effect of CA in patients with TMP and to evaluate TMP as a prognostic factor for AF recurrence in these patients (TMP group), compared to controls with normal left ventricular ejection fraction (LVEF) and patients with heart failure due to structural cardiomyopathy (HF group).
  
  
  RESULTS
  The study groups included 659 consecutive patients undergoing CA between 2003 and 2011: TMP group (n = 61), HF group (n = 36) and control group (n = 562). Compared to controls, patients with TMP were younger, had a shorter AF course and more often had persistent AF. Regarding echocardiographic parameters, the TMP group had lower LVEF (40% vs. 62%, P < 0.05), larger left atrial diameter (LAD: 46 vs. 41 mm, P < 0.05) and LV end-diastolic diameter (LVEDD: 55 vs. 51 mm, P < 0.05) compared to controls, with significant improvement at six-month follow-up, including those patients with AF recurrence. The probability of being arrhythmia-free did not differ between the TMP group and the other groups after a first or last procedure. The only independent predictor of AF recurrence was LAD.
  
  
  CONCLUSIONS
  Patients with tachycardiomyopathy secondary to AF benefit from CA, with a significant improvement in LVEF, LVEDD and LAD. The outcome after CA of this group did not differ from patients with no structural cardiomyopathy.
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Catalonia, Spain; Institut d'Investigació Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Catalonia, Spain.
authors.forename: Naiara
authors.initials: N
authors.lastname: Calvo
authors.forename: Felipe
authors.initials: F
authors.lastname: Bisbal
authors.forename: Esther
authors.initials: E
authors.lastname: Guiu
authors.forename: Pablo
authors.initials: P
authors.lastname: Ramos
authors.forename: Mercé
authors.initials: M
authors.lastname: Nadal
authors.forename: Jose María
authors.initials: JM
authors.lastname: Tolosana
authors.forename: Elena
authors.initials: E
authors.lastname: Arbelo
authors.forename: Antonio
authors.initials: A
authors.lastname: Berruezo
authors.forename: Marta
authors.initials: M
authors.lastname: Sitges
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.forename: Lluís
authors.initials: L
authors.lastname: Mont
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D017115:Catheter Ablation / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery; D013610:Tachycardia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Atrial fibrillation; Catheter Ablation; Heart Failure; Tachycardiomyopathy