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Structural and functional inverse cardiac remodeling after cavotricuspid isthmus ablation in patients with typical
Javier García-Seara1, Francisco Gude, Pilar Cabanas-Grandío
1Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. Javier.Garcia.Seara@sergas.es
Insights
Cavotricuspid isthmus ablation significantly improves cardiac structure and function in typical atrial flutter patients. One-year follow-up shows reduced atrial size, improved ejection fraction, and better diastolic function.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Remodeling
Background:
- Typical atrial flutter is a common supraventricular tachycardia.
- Cavotricuspid isthmus ablation is a standard treatment for typical atrial flutter.
- Understanding long-term cardiac changes post-ablation is crucial.
Purpose of the Study:
- To assess structural and functional cardiac changes one year after cavotricuspid isthmus ablation for typical atrial flutter.
- To evaluate the impact of ablation on atrial size, ventricular dimensions, and cardiac function.
Main Methods:
- Prospective study of 95 patients undergoing cavotricuspid isthmus ablation.
- Echocardiography performed at baseline (post-procedure) and 1-year follow-up.
- Analysis of structural parameters (atrial/ventricular dimensions) and functional parameters (ejection fraction, diastolic function).
Main Results:
- 89 patients completed 1-year follow-up.
- Significant reduction in right and left atrial areas and ventricular diameters observed.
- Substantial improvement in left ventricular ejection fraction, right atrium contraction fraction, and diastolic function (60% to 81% improved from grade III to I).
- Reduction in pulmonary hypertension noted.
Conclusions:
- Cavotricuspid isthmus ablation leads to inverse cardiac remodeling in typical atrial flutter patients.
- One-year follow-up demonstrates significant improvements in cardiac function, including left ventricular ejection fraction and diastolic function.
- Ablation is effective in reversing detrimental cardiac changes associated with typical atrial flutter.
Introduction And Objectives:
The purpose of the present study is to determine the structural and functional cardiac changes that occur in patients at 1-year follow-up after ablation of typical atrial flutter.
Methods:
We enrolled 95 consecutive patients referred for cavotricuspid isthmus ablation. Echocardiography was performed at ≤6h post-procedure and 1-year follow-up.
Results:
Of 95 patients initially included, 89 completed 1-year follow-up. Hypertensive cardiopathy was the most frequently associated condition (39%); 24% of patients presented low baseline left ventricular systolic dysfunction. We observed a significant reduction in right and left atrial areas, end-diastolic and end-systolic left ventricular diameters, and interventricular septum. We observed substantial improvement in right atrium contraction fraction and left ventricular ejection fraction, and a reduction in pulmonary hypertension. Changes in diastolic dysfunction pattern were observed: 60% of patients progressed from baseline grade III to grade I; at 1-year follow-up, this improvement was found in 81%. We found no structural differences between paroxysmal and persistent atrial flutter at baseline and 1-year follow-up, exception for basal diastolic function.
Conclusions:
In patients with typical atrial flutter undergoing cavotricuspid isthmus catheter ablation, we found inverse structural and functional cardiac remodeling at 1-year follow-up with much improved left ventricular ejection fraction, right atrium contraction fraction, and diastolic dysfunction pattern. Full English text available from:www.revespcardiol.org.
