Successful catheter ablation of persistent atrial fibrillation is associated with improvement in functional tricuspid regurgitation and right heart reverse remodeling

• Published in: Heart and vessels Vol. 35; no. 6; pp. 842 - 851
• Main Authors: Itakura, Kiho, Hidaka, Takayuki, Nakano, Yukiko, Utsunomiya, Hiroto, Kinoshita, Mirai, Susawa, Hitoshi, Harada, Yu, Izumi, Kanako, Kihara, Yasuki
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.06.2020; Springer Nature B.V
• Subjects: Ablation; Aged; Atria; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Atrium; Biomedical Engineering and Bioengineering; Cardiac arrhythmia; Cardiac Surgery; Cardiology; Catheter Ablation; Catheters; Coronary artery disease; Correlation analysis; Electrocardiography; Female; Fibrillation; Heart diseases; Humans; Male; Medical instruments; Medicine; Medicine & Public Health; Middle Aged; Morphology; Multivariate analysis; Original Article; Radiofrequency ablation; Recovery of Function; Regurgitation; Retrospective Studies; Treatment Outcome; Tricuspid Valve - diagnostic imaging; Tricuspid Valve - physiopathology; Tricuspid Valve Insufficiency - diagnostic imaging; Tricuspid Valve Insufficiency - physiopathology; Vascular Surgery; Ventricular Function, Right; Ventricular Remodeling; Echocardiography; Atrial tricuspid regurgitation; Right atrium; Atrial fibrillation
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-019-01546-3

Atrial fibrillation (AF) is a common disease that changes cardiac morphology, especially in the left atrium (LA). It is now known that certain categories of functional mitral regurgitation (MR) are associated with AF; however, the influence of AF on right cardiac morphology is not fully understood. Our aim in this study was to investigate the association between AF and right cardiac morphology. This was a retrospective cohort study of 86 patients with persistent AF without other cardiac disease who underwent catheter ablation (CA). Seventy-one patients had sustained sinus rhythm (SR) (SR Group) and 15 patients had sustained AF (AF Group) during the study period. We compared the changes in the right cardiac dimensions and tricuspid regurgitation (TR) between the groups 12 months after CA. Patients’ baseline echocardiographic assessments revealed that the LA volume index was significantly smaller in the SR group than in the AF group (46.8 ± 11.9 ml/m 2 vs 59.3 ± 12.8 ml/m 2 , respectively; p  < 0.01). Comparing baseline data with the 12-month follow-up data, in the SR group, right atrial area (RAA, cm 2 ), tricuspid annular diameter (mm), and tricuspid regurgitant jet area (cm 2 ) were significantly decreased compared with the AF group (19.5 ± 4.5–15.5 ± 3.6 vs 20.7 ± 3.6–19.7 ± 2.3; 30.5 ± 4.9–26.4 ± 3.9 vs 28.7 ± 4.0–28.8 ± 3.1; and 1.4 [interquartile range (IQR) 0.7–2.6]–0.6 [IQR 0.2–1.2] vs 1.2 [IQR 1.1–1.5]–0.9 [IQR 0.4–1.3], respectively). On multivariate analysis, change in RAA correlated with the reduction in tricuspid regurgitant jet area ( R  = 0.51, p  < 0.001). In conclusion, successful CA for persistent AF led to right heart reverse remodeling, and our findings suggested that persistent AF was associated with RAA dilatation and TR.