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Effect of Atrial Radiofrequency Ablation Designed to Cure Atrial Fibrillation on Atrial Mechanical Function
Author(s) -
THOMAS STUART P.,
NICHOLSON IAN A.,
NUNN GRAHAM R.,
REES ARIANWEN,
TRIEU LAWRENCE,
DALY MICHAEL P.J.,
WALLACE ELISABETH M.,
ROSS DAVID L.
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2000.tb00740.x
Subject(s) - medicine , atrial fibrillation , cardiology , ablation , p wave , radiofrequency ablation , diastole , atrium (architecture) , blood pressure
RF Ablation for AF and Atrial Contractile Function. Introduction : The effects of linear radiofrequency lesions in the atria for cure of atrial fibrillation on atrial contraction have not previously been quantified. Methods and Results : Atrial function was measured before and 30 ± 24 days after a biatrial ablation procedure designed to cure atrial fibrillation in eight dogs and after a sham procedure in three dogs. Atrial mechanical function was assessed using Doppler diastolic blood flow velocities, atrial systolic pressure wave amplitude, and assessment of atrial contribution to cardiac output estimated by comparison of AV sequential pacing to ventricular pacing at the same heart rate. The mitral Doppler A/E velocity ratio was 1.03 ± 0.45 before and 0.72 ± 0.43 after ablation (P = 0.048). The tricuspid A/E ratio was 0.88 ± 0.17 before and 0.71 ± 0.12 after ablation (P = 0.04). The estimated atrial contribution to cardiac output was 18%± 9% before and 5%± 4% after ablation (P < 0.01). The left atrial systolic pressure wave amplitude was 2.8 ± 1.5 mmHg before and 1.7 ± 1.0 mmHg after ablation (P = 0.1). These changes were not observed in control dogs. Lesions covered 25%± 6% of tbe atrial endocardia) surface. Conclusion : Multiple linear radiofrequency lesions in the atria designed to cure atrial fibrillation may impair atrial contractility. Reduced atrial function is partly due to loss of atrial myocardial mass, but regional delays in atrial activation and splinting of the atria by scarring also may contribute.