Improvement of Hemodynamic Parameters in Patients With Preserved Left Ventricular Systolic Function by Catheter Ablation of Atrial Fibrillation - A Prospective Study Using Impedance Cardiography

Circ J. 2018 Dec 25;83(1):75-83. doi: 10.1253/circj.CJ-18-0911. Epub 2018 Oct 30.

Abstract

Background: The effects of catheter ablation for atrial fibrillation (AF) on hemodynamic parameters in patients with preserved left ventricular (LV) systolic function are unclear. Methods and Results: We enrolled 178 patients with AF (paroxysmal, 108; persistent, 70) with preserved LV systolic function who underwent AF ablation. The stroke volume index (SVI) was repeatedly measured using impedance cardiography. Reduced SVI (SVI, <33 mL/m2) was observed in 55% of patients before ablation. In patients with paroxysmal AF, the SVI did not change immediately after ablation (from 35±6 mL/m2to 35±5 mL/m2; P=0.652); however, it increased 1 month after ablation and further increased 6 months after ablation (1 month, 37±6 mL/m2, P<0.001; 6 months, 38±6 mL/m2, P<0.001). In patients with persistent AF, the SVI increased immediately after ablation (from 30±5 mL/m2to 36±6 mL/m2; P<0.001) and further increased until 6 months after ablation (1 month, 37±6 mL, P<0.001; 6 months, 38±5 mL/m2, P<0.001). The baseline SVI was the strongest predictor of the cardiac function improvement with an area under the curve of 0.828.

Conclusions: The restoration and maintenance of sinus rhythm using catheter ablation increased the SVI in patients with preserved LV systolic function.

Keywords: Atrial fibrillation; Cardiac function; Catheter ablation; Impedance cardiography; Stroke volume.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Atrial Fibrillation* / physiopathology
  • Atrial Fibrillation* / surgery
  • Cardiography, Impedance*
  • Catheter Ablation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Stroke Volume*
  • Ventricular Function, Left*