Related Experiment Video

Updated: Jun 6, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

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Characterisation of patients who develop atrial fibrillation-induced cardiomyopathy

Nikhil Ahluwalia1,2, Shohreh Honarbakhsh1,2, Hakam Abbass1

  • 1St Bartholomew's Hospital, London, UK.

Open Heart
|November 28, 2024
PubMed

Insights

Atrial fibrillation (AF)-induced cardiomyopathy (AIC) patients often have persistent cardiac dysfunction even after normal left ventricular ejection fraction (LVEF) in sinus rhythm. These findings suggest a subtle underlying cardiomyopathic process.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Heart Failure Research

Background:

  • Atrial fibrillation (AF)-induced cardiomyopathy (AIC) is defined by reduced left ventricular ejection fraction (LVEF) that normalizes after rhythm restoration.
  • The underlying mechanisms and predisposing factors for AIC remain incompletely understood.
  • Identifying persistent cardiomyopathic features post-ablation could elucidate disease progression.

Purpose of the Study:

  • To assess cardiac function using detailed measures after successful catheter ablation (CA) in patients with AIC.
  • To identify subtle cardiomyopathic features that persist even after LVEF normalization in AIC patients.
  • To evaluate the utility of specific biomarkers and functional tests in detecting these persistent abnormalities.

Main Methods:

  • Prospective evaluation of patients with persistent AF and LVEF <50% undergoing CA.
  • Utilized echocardiography, cardio-pulmonary exercise testing, and NT-proBNP levels at baseline and 6 months post-CA.
  • Assessed left ventricular longitudinal strain, left atrial reservoir strain (LARS), and functional capacity markers in AIC patients with recovered LVEF.

Main Results:

  • 82.9% of participants recovered LVEF post-CA, meeting AIC criteria.
  • Elevated NT-proBNP and persistent heart failure symptoms were common.
  • Impaired LV longitudinal strain (58.8%) and LARS (26.5%) were observed, with significant overlap.
  • 50% of patients with AIC had no traditional cardiovascular risk factors.

Conclusions:

  • Patients with AIC exhibit persistent structural, metabolic, and heart failure biomarker abnormalities in sinus rhythm.
  • These findings suggest a pre-existing, subtle cardiomyopathic process that predisposes individuals to AF-related left ventricular dysfunction.
  • Further research is warranted to understand the etiology and implications of these persistent abnormalities.
Abstract

Keywords:
Atrial FibrillationCardiomyopathiesCatheter Ablation

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