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The effects of catheter ablation of outflow tract premature ventricular complexes on atrial electromechanical delay
Hakan Çakır1, Selçuk Kanat2, Ali Karagöz1
1Department of Cardiology, Kartal Kosuyolu Cardiovascular Research and Training Hospital, Health Sciences University, Istanbul, Turkey.
Insights
Radiofrequency catheter ablation (RFCA) for frequent premature ventricular complexes (PVCs) improves atrial electromechanical delay (EMD). These positive effects on interatrial and intra-atrial EMDs occur regardless of the patient's baseline left ventricular ejection fraction (LVEF).
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Catheter ablation of frequent premature ventricular complexes (PVCs) improves left ventricular function and atrial mechanics.
- However, the impact of PVC ablation on atrial electromechanical properties remains uninvestigated.
Purpose of the Study:
- To investigate the short-term effects of radiofrequency catheter ablation (RFCA) on atrial electromechanical delay (EMD) in patients with outflow tract PVCs.
- To assess if these effects differ based on preprocedural left ventricular ejection fraction (LVEF).
Main Methods:
- Seventy-one patients with idiopathic outflow tract PVCs undergoing RFCA were enrolled.
- Interatrial and intra-atrial EMDs were measured using tissue Doppler imaging before and 3 months post-ablation.
- Patients were stratified into normal and low LVEF subgroups.
Main Results:
- Significant improvements were observed in various electromechanical coupling times and EMDs across all patients post-RFCA.
- These improvements included interatrial, left-sided intra-atrial, and right-sided intra-atrial EMDs.
- No significant differences in the improvement of atrial EMDs were noted between the low-EF and normal-EF subgroups.
Conclusions:
- RFCA for outflow tract PVCs demonstrates a beneficial early effect on intra- and inter-atrial electromechanical delay.
- This positive impact is consistent across patients, irrespective of their initial left ventricular ejection fraction.
Background:
Consistent data from several studies have shown that catheter ablation of frequent premature ventricular complexes (PVCs) results in substantial improvement in left ventricular ejection fraction (LVEF), left ventricular diastolic function, and left atrial volume and mechanics. However, the effects of catheter ablation of PVCs on atrial electromechanical properties have not been documented yet.
Aims:
In the present study, we investigated the short-term effects of radiofrequency catheter ablation (RFCA) of outflow tract PVCs on atrial electromechanical delay (EMD).
Methods:
A total of 71 subjects with idiopathic outflow tract PVCs who underwent RFCA were included. Interatrial and intra-atrial EMDs were measured by tissue Doppler imaging before and 3 months after catheter ablation.
Results:
The study population was divided into normal ejection fraction (EF) and low-EF subgroups according to their LVEF. In all study groups, substantial improvement was found in lateral electromechanical coupling time (PA), septal PA, right ventricular PA, interatrial EMD, left-sided intra-atrial EMD, and right-sided intra-atrial EMD. No treatment heterogeneity was observed when comparing low-EF and normal-EF subgroups with respect to atrial EMDs (interatrial EMD, interaction p = .29; left-sided intra-atrial EMD, interaction p = .13; right-sided intra-atrial EMD, interaction p = .88).
Conclusion:
RFCA of outflow tract PVC has a favorable early effect on intra- and inter-atrial EMDs irrespective of preprocedural LVEF.
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