Improvement of left atrial function and left atrial reverse remodeling after minimally invasive radiofrequency ablation evaluated by 2-dimensional speckle tracking echocardiography

Objective: The present study was aimed at demonstrating the beneficial effect of minimally invasive radiofrequency surgical ablation on left atrial remodeling using 2-dimensional speckle-tracking echocardiography. Methods: The study population consisted of 33 patients (mean age, 64.6 +/- 6.9 years; 84.8% men) with paroxysmal lone atrial fibrillation undergoing minimally invasive radiofrequency surgical ablation at our institution (University Hospital Maastricht, Maastricht, The Netherlands) from 2007 to 2011. The control group included 20 age- and gender-matched healthy adults. The left atrial peak systolic strain, peak strain rate, peak early diastolic strain rate, and peak negative strain rate were measured. Left atrial reverse remodeling was defined as a reduction in the left atrial volume index of 15% or greater. Results: The peak systolic strain was lower in patients with atrial fibrillation than in the controls (P <.001). It had increased significantly at 3 months (P <.001) and 12 months (P = .01) after surgery. Similarly, the peak strain rate (P <.001) was lower in patients with atrial fibrillation but had increased 3 months (P = .004) and 12 months (P = .001) after surgery. Finally, the peak early diastolic strain rate (P <.001) and peak negative strain rate (P <.001) were less negative at baseline compared with the rates in the controls. Both indexes had improved significantly at the follow-up examinations (3 months, P = .008 and P = .02; 12 months, both P = .01). Left atrial reverse remodeling occurred in 60.6% of patients at 3 months and 72.7% at 12 months postoperatively. Conclusions: Minimally invasive radiofrequency ablation resulted in significant left atrial reverse remodeling and significant improvement in left atrial compliance and function after restoration of sinus rhythm, as demonstrated by 2-dimensional speckle-tracking echocardiography analysis. Our findings need to be confirmed by additional and larger prospective studies.