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Abstract:

Introduction: left atrial (LA) volumes measured during different phases of the cardiac cycle can be used for the evaluation of the LA functional properties before and after catheter ablation (CA). Increase of LA ejection fraction (EF) supposed to be early and more sensitive marker of LA reverse remodeling process, than LA volume and can be important for assessing the effectiveness of CA.

Aim: was to estimate volumetric parameters and function of LV before and after cryo- and radiofrequency catheter ablation of pulmonary veins in patients with paroxysmal atrial fibrillation.

Materials and methods: 21 patients with paroxysmal atrial fibrillation (AF) were included in study. All patients underwent multidetector computed tomography (MDCT) of pulmonary veins (PV) and LA before CA and 12±2 months after CA. 3-dimensional images at phases 0%, 40%, 75% of the cardiac cycle were used to assess LA functional properties.

Results: LA maximal volume before CA was increased insignificantly in patients with AF recurrence (124,52±38,22 ml vs. 117,89±23,94 ml, p>0,05). In patients without recurrence after CA, LA volumes decreased slightly (LA max 115,31±20,13 ml, p>0,05, LA min 73,43±14,91 ml, p>0,05), while in patients with recurrence increased (LA max 130,88±25,20 ml, p<0,05, LA min to 94,92±31,75 ml, p<0,05). Global LA ejection fraction was less in patients without recurrence before CA (22,37%±4,69 vs. 31,31%±9,89, p=0,013), but increased significantly after CA, while in patients with recurrence global LA EF was without relevant changes (36,54%±3,27 vs. 28,89%±9,41, p=0,011).

Conclusion: improved left atrial mechanical function was demonstrated in patients without any recurrence after ablation. The anatomic and functional reverse remodeling was not significant in patients with atrial fibrillation recurrence.

  

 

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