Reverse Left Atrial Remodeling Assessment after Paroxysmal Atrial Fibrillation Ablation: Our First Experience

REVERSE LEFT ATRIAL REMODELING ASSESSMENT AFTER PAROXYSMAL ATRIAL FIBRILLATION ABLATION: OUR FIRST EXPERIENCE (Abstract) We aimed to assess reverse left atrial (LA) remodeling at 6 months after ablation of paroxysmal atrial fibrillation (AF), and to identify the most relevant parameter of reverse LA remodeling. Material and methods: Left atrial size was assessed by echocardiography: antero-posterior (AP) diameter, LA area in apical 4 and 2 chambers (A4c, A2c), LA volume by biplane formula (LAV1), and by computed-tomography (LAV2). Results: Seventy-eight consecutive patients with mean age of 57.41 ± 8.05 years were prospectively included; 60 (76.9%) were with paroxysmal AF less than 24 hours and 18 (23.1%) less than 7 days duration. All echocardiographic and computed-tomographic evaluations were made within 4 weeks before ablation and at 6 months after ablation procedure by the same operator. Circumferential or segmental pulmonary vein isolation was performed by radiofrequency in 58 (74.4%) patients, and by cryotherapy in 18 (23.1%) patients. At 6 months 53 (67.9%) patients were in stable sinus rhythm and 18 (23%) out of those on antiarrhythmic drugs. At 6 months after ablation all parameters of LA size decreased statistically significant. Conclusions: In our first experience, endocardial catheter ablation results in significant conversion in sinus rhythm in patients with paroxysmal AF. The maintenance of stable sinus rhythm after abl ation procedure determined a significant reverse LA remodeling, irrespective of parameter used for LA size assessment. The most relevant parameter for assessing reverse LA remodeling in patients with endocardial ablation of paroxysmal AF was LA volume by echocardiography.