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Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function
G Santarpino1, A S Rubino, F Onorati
1Cardiac Surgery Unit, Magna Graecia University, Catanzaro, Italy.
Minerva Cardioangiologica
|February 3, 2011
Summary
Surgical radiofrequency ablation for atrial fibrillation (AF) successfully restored sinus rhythm (SR) in 76.8% of patients. Maintaining SR significantly improved clinical outcomes and cardiac function, reducing hospital readmissions and heart failure.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- The atrio-ventricular response to surgical atrial fibrillation (AF) ablation is not well understood.
- Factors influencing AF recurrence after surgical ablation remain a subject of debate.
Purpose of the Study:
- To investigate the anatomo-functional response to successful surgical AF ablation.
- To identify determinants of AF recurrence following surgical ablation.
Main Methods:
- Sixty-nine patients underwent AF ablation during major cardiac surgery.
- Clinical and echocardiographic results were assessed post-ablation.
- Freedom from AF, rehospitalization, and congestive heart failure (CHF) were secondary outcomes; predictors of AF recurrence were evaluated.
Main Results:
- 76.8% of patients achieved sinus rhythm (SR) at a mean follow-up of 31.4 months.
- SR patients showed significantly better freedom from re-hospitalization (98.1% vs. 62.5%) and CHF (94.7% vs. 77.8%).
- SR was associated with atrial and ventricular reverse remodeling and improved left ventricular systolic and diastolic function.
Conclusions:
- Radiofrequency AF ablation achieves a high rate of SR recovery (76.8%).
- Maintenance of SR post-ablation leads to improved clinical, hemodynamic, and echocardiographic results.
- Preoperative atrial diameter and tricuspid insufficiency predict AF recurrence.
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