title: Improvement of left ventricular diastolic function and left atrial reverse remodeling after catheter ablation of premature ventricular complexes.
abstract: OBJECTIVE
  Catheter ablation of premature ventricular complexes (PVC) improves left ventricular (LV) systolic performance in certain patients; however, the effect on diastolic function and left atrial (LA) remodeling is unclear. We assessed the effects of catheter ablation of PVCs on parameters of LV diastolic function and LA remodeling.
  
  
  METHODS
  Forty-seven patients (age 65 ± 10 years, 46 men) who underwent catheter ablation for symptomatic PVCs were evaluated using two-dimensional echocardiography before and 6 ± 2 months after ablation. The measured diastolic indices included mitral inflow parameters (E wave, A wave, E/A ratio, and deceleration time (DT)), mitral lateral annulus early diastolic velocity (Ea), and E/Ea ratio. The LA volume was measured using modified biplane Simpson's method. We also compared the changes in the left atrial volumes and left atrial volume index (LAVI) after PVC ablation.
  
  
  RESULTS
  After catheter ablation of PVCs, the mean LV ejection fraction (EF) increased significantly (49.9 ± 10.3 vs. 42.8 ± 11.8, p < 0.01). Significant improvement was also seen in A wave velocity (71.3 ± 17.1 vs. 59.5 ± 15.1 cm/s, p = 0.039), E/A ratio (1.42 ± 0.6 vs. 1.07 ± 0.5 ml, p = 0.034), Ea (8.9 ± 3.9 vs. 6.8 ± 2.9 cm/s, p = 0.04), and E/Ea ratio (15.4 ± 5.8 vs. 10.6 ± 3.4, p = 0.027), whereas mitral E and DT did not show significant change. LAVI decreased significantly after ablation (44.4 ± 14.8 vs. 36.7 ± 12.5, p < 0.001). Significant improvement in LAVI was also seen in patients with normal baseline LVEF (p = 0.04).
  
  
  CONCLUSIONS
  Catheter ablation of PVCs improved LV diastolic function and resulted in left atrial reverse remodeling.
authors.affiliation: Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akkaya
authors.forename: Henri
authors.initials: H
authors.lastname: Roukoz
authors.forename: Selcuk
authors.initials: S
authors.lastname: Adabag
authors.forename: David G
authors.initials: DG
authors.lastname: Benditt
authors.forename: Inder
authors.initials: I
authors.lastname: Anand
authors.forename: Jian Ming
authors.initials: JM
authors.lastname: Li
authors.forename: Marina
authors.initials: M
authors.lastname: Zakharova
authors.forename: Venkat
authors.initials: V
authors.lastname: Tholakanahalli
mesh_terms: D000368:Aged; D064752:Atrial Remodeling; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*