Evaluation Of Left Atrial Function With Two-dimensional Speckle Tracking Echocardiography In Patients Treated With Electrical Cardioversion And Catheter Ablation For Atrial Fibrillation

OBJECTIVE
The effects of radiofrequency catheter ablation (RFCA) and electrical cardioversion (DCCV) on left atrial (LA) mechanical function and atrial myopathy are not fully understood. In this study, we aimed to compare the changes in myocardial deformation after catheter ablation and electrical cardioversion procedures in patients with atrial fibrillation (AF).

METHOD
In this study, we retrospectively analyzed echocardiographic parameters of left ventricular and left atrial function and strain measurements with two-dimensional speckle tracking echocardiography (STE) before and after the procedure in patients who underwent RFCA or DCCV for atrial fibrillation.

RESULTS
LA reservoir strain (LARS) significantly improved after the procedure in the ablation group (Apical four chamber view LARS 15.1±8.2, 19.6±7.1 p<0.001, respectively). The Apical four chamber view LARS value also showed a significant improvement after the procedure compared to the pre-procedure in patients who underwent DCCV (Apical four chamber view LARS 12.2±6.2, 17.3±8.1 p<0.001, respectively). There was no significant difference in strain change between the groups (p=0.7).

CONCLUSION
In our study, the improvement in the reservoir strain of patients who underwent RFCA was similar to DCCV group. These findings suggest that restoration of sinus rhythm by RFCA, despite the expense of fibrosis in the lesion areas, improves left atrial reservoir function.