Improvement of left ventricular function in patients with persistent atrial tachyarrhythmia induced cardiomyopathy undergoing radiofrequency ablation

Xiangmin Shi, Zhaoliang Shan, Hongyang Guo, Yutang Wang

Department of Cardiology, PLA General Hospital, Beijing, China.

DOI: 10.4236/wjcd.2013.39084                

Abstract

Purpose: To investigate the alteration of left ventricular function in subjects with persistent atrial tachyarrhythmia induced cardiomyopathy (TIC) undergoing radiofrequency ablation, and to study the pathogenesis and effective treatment of TIC. Methods: A total of 25 cases with persistent atrial tachyarrhythmia and impaired left ventricular systolic function were studied (16 men and 9 women, aged 53.3 ± 15.2 years), and all subjects underwent electrophysiological study and radiofrequency ablation of atrial tachyarrhythmia under the guidance of CARTO system during 2006.9-2011.8. Indexes related to cardiac function, including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), New York Heart Association functional classification (NYHA class), 6 minutes walking test (6MWT), N-terminal pro-brain natriuretic peptide (BNP) and 24 hours average heart rate (AHR), were analyzed at the time point of 7 days, 3 and 6 months after the procedure as well as 1 day before ablation. Results: No refractory atrial arrhythmia recurred in all cases after ablation, compared with LVEDD (51.7 ± 4.5 mm), LVEF (39.0% ± 4.3%), number of patients with NYHA class IV and III (n = 17), 6MWT (212 ± 56 m), BNP (3622 ± 1860 ng/L) and AHR (112.5 ± 23.2 bpm) before ablation, the index of LVEDD (45.2 ± 3.3 mm; 41.7 ± 2.5 mm; 40.5 ± 3.1 m), BNP (2429 ± 1355 ng/L; 1530 ± 866 ng/L; 1300 ± 520 ng/L), total number of patients of NYHA class IV and III (n = 11; 3; 2) and AHR (73.3 ± 15.3 bpm; 68.7 ± 13.5 bpm; 66.3 ± 13.6 bpm) significantly decreased (P < 0.05), LVEF (45.6 ± 3.5%; 51.5 ± 2.7%; 53.5 ± 3.1%) and 6MWT (262 ±

47 m; 305 ± 37 m; 313 ± 41 m) greatly increased (P < 0.05）in 7 days, 3 and 6 months after ablation respectively. There was a statistical difference between 7 days and 3 or 6 months after ablation in above-mentioned indexes (P < 0.05) except AHR (P > 0.05), no significant difference existed between 3 and 6 months in all indexes (P > 0.05). Conclusion: long-lasting atrial arrhythmia with rapid ventricular response could impair left ventricle function, which could be reversed within weeks after successful ablation and restoration of sinus rhythm.

Keywords

Tachyarrhythmia-Induced Cardiomyopathy; Radiofrequency Ablation; Left Ventricular Dysfunction; Sinus Rhythm

Conflicts of Interest

The authors declare no conflicts of interest.

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