Abstract
Purpose: Atrial fibrillation(AF) causes structural, electrical,
and cellular remodeling in the atrium. Evaluation of intra- and
interatrial conduction time, which is measured by tissue doppler
echocardiography, indicates structural and electrical remodeling in the
atrium. The aim of this study was to evaluate the effect of pulmonary
vein isolation applied with RF ablation therapy on intra- and
interatrial conduction time and to investigate the structural and
electrically remodeling after treatment.
Methods: Fifty-two patients with symptomatic PAF despite at least
one antiarrhythmic drug and without structural heart disease were
included in the study. Two patients were excluded because of
complications developed during and after the operation. Fifty patients
(28 female; mean age: 51.68 ± 11.731; mean left atrial diameter: 36.79 ±
4.318) who underwent CARTO® 3D pulmonary vein isolation applied with the
RF ablation system were followed-up. Intra- and the inter-atrial
electromechanical delay was measured in all patients by tissue doppler
echocardiography before and three months after RF ablation.
Results: All intra-and interatrial conduction times were
significantly decreased 3 months after RF ablation procedure(PA lateral
p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial
conduction delay p= 0,012, intra-atrial conduction delay p = 0.029).
Conclusion: The results of our study suggest that providing stable
sinus rhythm by the elimination of the AF triggering mechanisms with RF
ablation of pulmonary vein isolation may slow down,stop or even improve
structural remodeling at substrate level secondary to AF even in
patients who did not yet develop atrial fibrosis and permanent
structural changes.
Keywords: Pulmonary vein isolation, Radiofrequency ablation,
Atrial conduction time, Tissue doppler echocardiography