Fate of left atrial function as determined by real-time three-dimensional echocardiography study after radiofrequency catheter ablation for the treatment of atrial fibrillation

Radiofrequency catheter ablation has been demonstrated to be effective in the treatment of patients with atrial fibrillation. However, its impact on left atrial (LA) function has not been widely studied. The purpose of the present study was to evaluate the impact of radiofrequency catheter ablation on LA function in patients with atrial fibrillation. Thirty-eight patients with symptomatic drug-refractory atrial fibrillation were treated with circumferential pulmonary vein ablation (CPVA). LA volumes and function were assessed with real-time 3-dimensional echocardiography before and 6 months after the procedure. The effectiveness of CPVA was evaluated at 6-month follow-up. Recurrence of the arrhythmia was defined as any documented (clinically or on 24-hour Holter electrocardiography) atrial tachyarrhythmia lasting > 30 seconds after the first 12 weeks after the procedure. CPVA induced a reduction of maximum LA volume (from 55 +/- 15 to 48 +/- 16 ml, p < 0.001), without impairment in LA function, measured as the active emptying percentage of total volume (32 +/- 29% vs 39 +/- 33%, p=NS). At follow-up, 21 patients (61.8%) had no recurrences. Maximum LA volumes were significantly larger in patients who presented with recurrences compared with those who did not (64 +/- 18 vs 50 +/- 11 ml, p=0.01). In conclusion, CPVA induces a reduction in LA volume without a deleterious impact on function, and, of importance, real-time 3-dimensional echocardiography is a useful non-invasive imaging tool to follow up LA remodeling and function in these patients. (c) 2008 Elsevier Inc. All rights reserved.