Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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The Effects of Radiofrequency Catheter Ablation for Atrial Fibrillation on Right Ventricular Function

  • Minkwan Kim (Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Jae-Sun Uhm (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Je-Wook Park (Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • SungA Bae (Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • In Hyun Jung (Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Seok-Jae Heo (Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine) ;
  • Daehoon Kim (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Hee Tae Yu (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Tae-Hoon Kim (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Boyoung Joung (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Moon-Hyoung Lee (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2023.11.25
  • Accepted : 2024.02.07
  • Published : 2024.04.01
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Abstract

Background and Objective: The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known. Methods: Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled consecutively. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain including the ventricular septum (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal AF (PAF), persistent AF (PeAF), and long-standing persistent AF (LSPeAF) groups. Results: 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). In patients without recurrence, improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared to the LSPeAF group. Conclusions: RV systolic function is more impaired in patients with PeAF and LSPeAF than in those with PAF. RV systolic function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.

Keywords

Acknowledgement

The authors thank Su Kyung Oh, BS from Biosense Webster, Johnson and Johnson, Inc. for her 3-dimensional electroanatomical mapping with CARTO. The authors thank sonographer Jin Hye Park from Yongin Severance Hospital for her measurement of the echocardiographic parameters. Medical Illustration & Design (MID)), a part of the Medical Research Support Services of Yonsei University College of Medicine, for providing excellent support with medical illustration.

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