The effects of radiofrequency catheter ablation for atrial fibrillation on right ventricular function

The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known.

Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal (PAF), persistent (PeAF), and long-standing persistent AF (LSPeAF) groups.

A total of 164 participants (74 PAF, 47 PeAF, and 43 LSPeAF; age, 60.8±9.8 years; men, 74.4%) was enrolled. The patients with PeAF and LSPeAF had worse RV4CSL (p<0.001) and RVFWSL (p<0.001) than those with PAF and reference values. Improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared with the PAF and LSPeAF groups (ΔRV4CSL, 8.4% [5.1–11.6] in PeAF vs. 1.0% [-1.0–4.1] in PAF, 1.9% [-0.2–4.4] in LSPeAF, p<0.001; ΔRVFWSL, 9.0% [6.9–11.5] in PeAF vs. 0.9% [-1.4–4.9] in PAF, 1.0% [-1.0–3.6] in LSPeAF, p<0.001).

RV function is impaired in patients with PeAF and LSPeAF than in those with PAF. RV function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.

Changes of echocardiographic parameters