Europace Advance Access originally published online on April 1, 2008
Europace 2008 10(5):593-599; doi:10.1093/europace/eun076
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ABLATION FOR ATRIAL FIBRILLATION
Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging
1 Department of Cardiology, University Hospital Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany; 2 Department of Radiology, University Hospital Eppendorf, Hamburg, Germany
Aims: Beneficial effects of atrial fibrillation (AF) ablation have been demonstrated in patients with congestive heart failure (CHF) and significantly impaired left ventricular ejection fraction (LVEF). However, the impact of pulmonary vein isolation (PVI) on cardiac function in patients with paroxysmal AF and impaired LVEF remains under discussion. This study aimed to evaluate the impact of PVI for paroxysmal AF on cardiac function in patients with impaired LVEF using cardiac magnetic resonance imaging (CMRI).
Methods and results: A total number of 70 patients with paroxysmal AF and episodes 
24 h were scanned on a 1.5-T-CMRI before and 6 months after PVI during sinus rhythm. End-diastolic volume, end-systolic volume, and LVEF were determined by epicardial and endocardial measurements. Patients were categorized into two groups regarding cardiac function as assessed by CMRI: group 1 patients (n = 18) with an LVEF < 50% and patients with an LVEF > 50% (group 2, n = 52). Group 1 patients demonstrated a significant lower success rate than patients of group 2 after a follow-up of 152 ± 40 days (50 vs. 73%, P < 0.05). Cardiac magnetic resonance imaging in group 1 patients demonstrated a significant improvement in cardiac function after AF ablation (41 ± 6 vs. 51 ± 12%, P = 0.004), whereas group 2 patients did not show significant differences (60 ± 6 vs. 59 ± 9%, P = 0.22) after a 6 months follow-up.
Conclusion: Pulmonary vein isolation improves cardiac function in patients with paroxysmal AF and impaired LVEF. These data suggest that an impaired LV function can be partially attributed to AF with short-lasting paroxysms.
Key Words: Atrial fibrillation, Catheter ablation, Pulmonary vein isolation, Congestive heart failure, Cardiac magnetic resonance imaging
* Corresponding author. Tel: +49 40 428034120; fax: +49 40 428034125.E-mail address: lutomsky{at}uke.uni-hamburg.de
Manuscript submitted 12 December 2007. Accepted after revision 10 March 2008.
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