The Effects of Radiofrequency Catheter Ablation for Atrial Fibrillation on Right Ventricular Function

Minkwan Kim; Jae-Sun Uhm; Je-Wook Park; SungA Bae; In Hyun Jung; Seok-Jae Heo; Daehoon Kim; Hee Tae Yu; Tae-Hoon Kim; Boyoung Joung; Moon-Hyoung Lee

doi:10.4070/kcj.2023.0312

The Effects of Radiofrequency Catheter Ablation for Atrial Fibrillation on Right Ventricular Function

Korean Circ J. 2024 Apr;54(4):203-217. doi: 10.4070/kcj.2023.0312.

Authors

Minkwan Kim¹, Jae-Sun Uhm², Je-Wook Park¹, SungA Bae¹, In Hyun Jung¹, Seok-Jae Heo³, Daehoon Kim⁴, Hee Tae Yu⁴, Tae-Hoon Kim⁴, Boyoung Joung⁴, Moon-Hyoung Lee⁴

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
² Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jason@yuhs.ac.
³ Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea.
⁴ Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Background and objective: The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known.

Methods: Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled consecutively. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain including the ventricular septum (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal AF (PAF), persistent AF (PeAF), and long-standing persistent AF (LSPeAF) groups.

Results: A total of 164 participants (74 PAF, 47 PeAF, and 43 LSPeAF; age, 60.8 ± 9.8 years; men, 74.4%) was enrolled. The patients with PeAF and LSPeAF had worse RV4CSL (p<0.001) and RVFWSL (p<0.001) than those with PAF and reference values. Improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared with the PAF and LSPeAF groups (ΔRV4CSL, 8.4% [5.1, 11.6] in PeAF vs. 1.0% [-1.0, 4.1] in PAF, 1.9% [-0.2, 4.4] in LSPeAF, p<0.001; ΔRVFWSL, 9.0% [6.9, 11.5] in PeAF vs. 0.9% [-1.4, 4.9] in PAF, 1.0% [-1.0, 3.6] in LSPeAF, p<0.001). In patients without recurrence, improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared to the LSPeAF group.

Conclusions: RV systolic function is more impaired in patients with PeAF and LSPeAF than in those with PAF. RV systolic function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.

Keywords: Atrial fibrillation; Catheter ablation; Right ventricle; Strain; Ventricular function, right.