Impact du traitement par ablation de la fibrillation atriale paroxistiques isolée sur le remodelage ventriculaire gauche [Early and late cardiac ventricular reverse remodeling after catheter ablation for lone paroxysmal atrial fibrillation.] - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Annales de Cardiologie et d'Angéiologie Année : 2011

Impact du traitement par ablation de la fibrillation atriale paroxistiques isolée sur le remodelage ventriculaire gauche [Early and late cardiac ventricular reverse remodeling after catheter ablation for lone paroxysmal atrial fibrillation.]

Résumé

AIM: We sought to explore ventricular function in patients with lone paroxysmal atrial fibrillation (AF) and determine the mid- and long-term impact of pulmonary vein isolation on cardiac remodeling. BACKGROUND: The relationship between tachyarrhythmia and ventricular dysfunction is still a matter of debate. Tachycardia-induced cardiomyopathy is defined as reversible myocardial dysfunction following treatment for tachyarrhythmia. METHOD: We prospectively studied 31 patients (56.4 ± 10 years) presenting with paroxysmal-AF who were treated successfully by catheter ablation and 15 age-matched controls. Left and right ventricular functions were assessed by echocardiography at baseline and at 3-month and 1-year follow-up. RESULTS: In AF-patients, LV-function was slightly lower at baseline than controls (LV-ejection fraction was 60% versus 64%; P = 0.06). More impressive, systolic peak velocity on Doppler tissue imaging was 9 cm/s in AF patients (versus 12 cm/s; P = 0.0004). LV global longitudinal strain was also significantly different between the two groups (patients: -16% versus controls: -19%; P = 0.005). At 1-year follow-up, most functional parameters significantly improved in the AF-patients and no longer differed from the controls. Right ventricular (RV) function was also depressed in AF patients at baseline. At 1-year follow-up, tissue Doppler showed improvement in RV-S' (+27%, P = 0.007) and RV peak systolic strain (+36%, P<0.0001) and became comparable to controls. CONCLUSION: We demonstrate that some degree of arrhythmic cardiomyopathy exists in patients presenting with lone paroxysmal-AF. Catheter ablation improved RV and LV functions. Longitudinal function is the most sensitive component of ventricular systole to monitor when looking for this cardiac reverse remodeling.

Dates et versions

hal-00908062 , version 1 (22-11-2013)

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Citer

Romain Ollivier, Erwan Donal, D. Veillard, D. Pavin, S. Hamonic, et al.. Impact du traitement par ablation de la fibrillation atriale paroxistiques isolée sur le remodelage ventriculaire gauche [Early and late cardiac ventricular reverse remodeling after catheter ablation for lone paroxysmal atrial fibrillation.]. Annales de Cardiologie et d'Angéiologie, 2011, 60 (1), pp.1-8. ⟨10.1016/j.ancard.2010.08.002⟩. ⟨hal-00908062⟩
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