Very early cardiac hemodynamic changes after atrial fibrillation ablation

Background: All chambers’ systolic functions were improved with long-term follow-up after catheter ablation (CA). However, changes on cardiac function on very early phase (within 48 hours) has not been thoroughly investigated.

Objectives: This study aimed to evaluate the acute effects of CA on cardiac function and morphology immediately post-procedural (≤ 48 hours).

Methods: We prospectively enrolled 117 consecutive patients. Hemodynamic parameters including biatrial pressure and echocardiographic data were acquired pre- and post-ablation.

Results: (i) All bi-atrial pressures significantly elevated post-ablation (p?0.002). (ii) Bi-atrial function including ejection fraction, reservoir strain and conduit strain improved immediately after ablation (p?0.01). Persistent atrial fibrillation (AF) improved more than paroxysmal AF. (iii) Biventricular systolic function improved early but left ventricular diastolic function was stunned within 48 hours (p?0.01). Whereas all chambers’ volume did not change significantly (p?0.05). (iv) No statistically significant differences in pre- versus post-procedural pressure changed between patients with persistent AF and those with paroxysmal AF in biatrial pressure elevation (p?0.05). (v) Echocardiographic parameters including LA reservoir strain, RA reservoir strain, peak A of mitral valve, peak E of tricuspid valve and inferior vena cava diameters increased more in persistent AF groups (p?0.05).

Conclusions: This prospective study suggested all chambers’ systolic functions improved in early period post-ablation with left ventricular diastolic function stunning. Mechanical improvements preceding structural remodeling in AF patients early after ablation.

Dr. Hu Wanyu is a cardiac ultrasound specialist with over 10 years of experience in echocardiography. Currently pursuing a Ph.D. at Zhejiang University, she has published four SCI-indexed papers and has led one Hangzhou Medical and Health Science and Technology Project.