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Europace Advance Access published online on July 14, 2008
Europace, doi:10.1093/europace/eun187
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Biatrial anatomical reverse remodelling after radiofrequency catheter ablation for atrial fibrillation: evidence from real-time three-dimensional echocardiography

Hajo Müller, Stephane Noble, Pierre-Frédéric Keller, Philippe Sigaud, Pascale Gentil, René Lerch, Dipen Shah and Haran Burri*

Cardiology Service, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva, Switzerland

Aims: Reports using two-dimensional echocardiography have indicated that radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) results in a reduction in the left atrial (LA) size. Furthermore, the effect of pulmonary vein isolation (PVI) on right atrial (RA) anatomical remodelling has not been studied. Three-dimensional echocardiography (3DE) allows us to more precisely quantify atrial volume. Our aim was to assess the effect of PVI on biatrial anatomical remodelling using real-time 3DE.

Methods and results: We prospectively studied 91 patients (age 59 ± 8 years, 79 males) referred for RFCA of paroxysmal (n = 79) or chronic (n = 19) AF. Left atrial and RA volumes were measured using real-time 3DE at baseline and after 6 months of follow-up. Data on AF recurrences were also collected. Left atrial volume was significantly reduced at follow-up when compared with baseline (51 ± 16 vs. 60 ± 21 mL, P < 0.001). The same occurred with RA volume (43 ± 17 vs. 50 ± 20 mL, P = 0.001). The reduction in the LA volume was more marked in patients with chronic than in those with paroxysmal AF (17 ± 16 vs. 6 ± 17 mL, P = 0.017). Patients with AF recurrence (23%) showed similar atrial volume reduction compared with those who were seemingly cured.

Conclusion: Three-dimensional echocardiography shows evidence of biatrial anatomical reverse remodelling after RFCA for AF. A reduction in the atrial volume occurs despite recurrence of AF.

Key Words: Atrial fibrillation, Radiofrequency ablation, Echocardiography, Remodelling, Three-dimensional echocardiography

* Corresponding author. Tel: +41 22 372 72 00; fax: +41 22 372 72 29. E-mail address: haran.burri{at}hcuge.ch

Manuscript submitted 15 April 2008. Accepted after revision 23 June 2008.


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