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Resolution of cardiomyopathy after ablation of atrial flutter

J A Luchsinger1, J S Steinberg

  • 1Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA.

Journal of the American College of Cardiology
|July 21, 1998
PubMed

Insights

Catheter ablation for atrial flutter significantly improved left ventricular (LV) function and heart failure symptoms in patients with tachycardia-induced cardiomyopathy. Most patients experienced LV function normalization and symptom resolution after the procedure.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • The link between atrial flutter (AFI) and tachycardia-induced cardiomyopathy is not well understood.
  • The impact of catheter ablation on left ventricular (LV) function in these patients remains unclear.

Purpose of the Study:

  • To evaluate changes in left ventricular (LV) function before and after radiofrequency ablation (RFA) for atrial flutter (AFI).
  • To assess the resolution of dilated cardiomyopathy and congestive heart failure (CHF) symptoms post-ablation.

Main Methods:

  • Serial assessment of LV function using two-dimensional echocardiography (measuring LV ejection fraction [LVEF]).
  • Evaluation of functional status using New York Heart Association (NYHA) CHF classification.
  • Study included 11 patients with successful RFA of AFI, dilated cardiomyopathy, and CHF symptoms.

Main Results:

  • Successful RFA of AFI led to a significant improvement in LVEF from 30.9% to 41.3% (p=0.005).
  • NYHA CHF class improved from 2.6 to 1.6 (p=0.002), with 55% of patients achieving LVEF normalization and symptom resolution.
  • Lower preablation LVEF and functional class predicted nonresolution of cardiomyopathy.

Conclusions:

  • Radiofrequency ablation (RFA) for atrial flutter (AFI) substantially improves LV function and resolves dilated cardiomyopathy in most patients.
  • Tachycardia-induced cardiomyopathy may be a frequent cause of LV dysfunction in AFI patients.
  • Aggressive treatment of AFI with RFA should be considered for patients with cardiomyopathy.
Abstract

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