Open AccessTransient manifestation of left ventricular diastolic dysfunction following ablation in patients with paroxysmal atrial fibrillation
Author(s) -
Minamisaka Tomoko,
Watanabe Tetsuya,
Shinoda Yukinori,
Ikeoka Kuniyasu,
Fukuoka Hidetada,
Inui Hirooki,
Ueno Keisuke,
Inoue Soki,
Mine Kentaro,
Hoshida Shiro
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22990
Subject(s) - medicine , ablation , cardiology , atrial fibrillation , ejection fraction , diastole , catheter ablation , radiofrequency ablation , heart failure , blood pressure
Background In patients with atrial fibrillation, ablation decreases left atrial (LA) compliance, which may lead to left ventricular (LV) diastolic dysfunction. We aimed to examine serial changes in LV diastolic function after 2 ablation procedures and their related factors in patients with paroxysmal atrial fibrillation (PAF). Hypothesis LV diastolic function is different after 2 ablation procedures. Methods We enrolled 132 patients with PAF (76 males, mean age 67 years; cryoballoon [CB] ablation/radiofrequency [RF] ablation 60/72) who underwent a single ablation procedure. The transthoracic echocardiographic parameters were obtained before, 3 days after, and 6 months after ablation. Results The afterload‐related index of LV diastolic function, Ed/Ea = E/e' / (0.9 × systolic blood pressure), increased significantly at 3 days after ablation, especially after CB ablation ( P <0.05), although no differences were observed in age, sex, LA size, LV size, and E/e' before ablation between CB ablation and RF ablation. Creatine kinase release after ablation was significantly higher in CB ablation than in RF ablation ( P <0.001). The increment of Ed/Ea after CB ablation was positively correlated with LV ejection fraction (LVEF) before ablation ( r =0.416; P <0.05). The elderly (age ≥ 75 years), females, and patients with hypertension were more likely to show impaired LV diastolic function transiently after 3 days of ablation, but the diastolic index was restored to baseline level after 6 months. Conclusions The increased Ed/Ea after CB ablation represented transient manifestation of underlying LV diastolic dysfunction in PAF patients with preserved LVEF with older age, female sex, and a history of hypertension.